Intra‐abdominal pressure, sagittal abdominal diameter and obesity comorbidity
Open accessAbstract
Objectives. To determine relationship of intraabdominal pressure to central obesity and the comorbidity of obesity. Design. Non‐randomized, prospective. Setting. University hospital, operating room. Subjects. Eighty‐four anaesthetized consecutive patients prior to gastric bypass for morbid obesity and five non‐obese patients before colectomy for ulcerative colitis. Main outcome measures. Weight, body mass index (BMI), co‐morbid history, sagittal abdominal diameter, waist:hip (W∶H) ratio and urinary bladder pressure, as an estimate of intra‐abdominal pressure. Results. Urinary bladder pressure was greater in the obese than the non‐obese (18±0.7 vs. 7±1.6 cm H 2 O, P < 0.001), correlated with sagittal abdominal diameter (r = +0.67, P < 0.001) and was greater (P < 0.05) in patients with, than those without, morbidity probably (hypoventilation, gastroesophageal reflux, venous stasis, stress incontinence, incisional hernia) or possibly (hypertension, diabetes) due to increased abdominal pressure. W∶H ratio correlated with urinary bladder pressure in men (r = +0.6, P < 0.05) but not women (r = −0.3). Conclusions. Increased sagittal abdominal diameter was associated with increased intraabdominal pressure which contributed to obesity‐related comorbidity. W∶H ratio was not a reliable indicator of intraabdominal pressure for women who often have both peripheral and central obesity. Further studies are needed to evaluate the relationship between intraabdominal pressure and Type II diabetes and hypertension.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Pressure in the abdominal cavity may be elevated to >40 cm H20 in patients with large sagittal abdominal diameters.
“Pressure in the abdominal cavity may be elevated to >40 cm H20 in patients with large sagittal abdominal diameters52.”
From Obesity, kidney dysfunction and hypertension: mechanistic links (2019) · cites this paper as [52]
In patients with visceral obesity, intra-abdominal pressure rises in proportion to sagittal abdominal diameter, reaching levels as high as 35-40 mmHg.
“In patients with visceral obesity, intra-abdominal pressure rises in proportion to sagittal abdominal diameter, reaching levels as high as 35–40 mmHg27.”
From Obesity-Induced Hypertension: Interaction of Neurohumoral and Renal Mechanisms (2015) · cites this paper as [27]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The publisher hasn’t deposited this paper’s reference list.
Research works printed but not linked: 36
- Folsom AR, Kaye SA, Sellers TA, Hong CP, Cerhan JR, Potier JD, Prineas RJ. Body fat distribution and 5-year risk of death in older women. JAMA 1993 ; 269 : 483-7.
- Gillum RF. The association of body fat distribution with hypertension, hypertensive heart disease, coronary heart disease, diabetes and cardiovascular risk factors in men and women aged 18-79 years. J Chronic Dis 1987 ; 40 : 421-8.
- Micciolo R, Bosello O, Ferrari P, Armellini F. The association of body fat location with haemodynamic and metabolic status in men and women aged 21-60 years. J Clin Epidemiol 1991 ; 44 : 591-608.
- Bjo$ rntorp P. Abdominal obesity and the metabolic syndrome. Ann Med 1992 ; 24 : 465-8.
- Johnson D, Prud'homme D, De! spre! s J-P, Nadeau A, Tremblay A, Bouchard C. Relation of abdominal obesity to hyper- insulinemia and high blood pressure in men. Int J Obes 1992 ; 16 : 881-90.
- Mauriege P, De! spre! s JP, Marcotte M, Ferland M, Tremblay A, Nadeau A, et al. Abdominal fat cell lipolysis, body fat distribution, and metabolic variables in premenopausal women. J Clin Endocrinol Metab 1990 ; 71 : 1028-35.
- Hackney JD, Crane MG, Collier CC, Rokaw S, Griggs DE. Syndrome of extreme obesity and hypoventilation : studies of etiology. Ann Intern Med 1959 ; 51 : 541-52.
- Dent J, Dodds WJ, Hogan WJ, Toouli J. Factors that influence induction of gastroesophageal reflux in normal human sub- jects. Dig Dis Sci 1988 ; 33 : 270-5.
- Nagler R, Spiro HM. Heartburn in late pregnancy : manometric studies of esophageal motor function. J Clin Invest 1961 ; 40 : 954-70.
- Lind JF, Smith AM, McIver DK, Coopland AT, Crispin JS. Heartburn in pregnancy-a manometric study. Can Med Assoc J 1968 ; 98 : 571-4.
- Jones MJ, Mitchell RW, Hindocha N. Effect of increased intraabdominal pressure during laparoscopy on the lower esophageal sphincter. Anesth Analg 1989 ; 68 : 63-5. # 1997 Blackwell Science Ltd Journal of Internal Medicine 241 : 71-79 13652796, 1997, 1, Downloaded from https://onlinelibrary.wiley.com/doi/10.1046/j.1365-2796.1997.89104000.x by Mount Vernon Nazarene University, Wiley Online Library on [17/08/2026]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License · DOI
- McClennan CE. Antecubital and femoral venous pressure in normal and toxemic pregnancy. Am J Obstet Gynecol 1943 ; 45 : 568-91.
- Skudder PA, Farrington DT. Venous conditions associated with pregnancy. Semin Dermatol 1993 ; 12 : 72-7.
- Bump RC, Sugerman HJ, Fantl JA, McClish DK. Obesity and lower urinary tract function in women : effect of surgically induced weight loss. Am J Obstet Gynecol 1992 ; 167 : 392-9.
- Sugerman HJ, Kellum JM, Reines HD, DeMaria EJ, Newsome HH, Lowry JW. Greater risk of incisional hernia with morbidly obese than steroid dependent patients and low recurrence with prefascial polypropylene mesh. Am J Surg 1966 ; 171 : 80-4.
- Metropolitan height and weight tables. Stat Bull Metrop Insur Co 1983 ; 64 : 2-9.
- Ridings PC, Bloomfield GL, Blocher CR, Sugerman HJ. Cardio- pulmonary effects of raised intraabdominal pressure before and after volume expansion. J Trauma 1995 ; 39 : 1071-5.
- Harman PK, Kron IL, McLachlan HD, Freedlander AE, Nolan SP. Elevated intraabdominal pressure and renal function. Ann Surg 1982 ; 196 : 594-7.
- Iberti TJ, Lieber CE, Benjamin E. Determination of intra- abdominal pressure using a transurethral bladder catheter : clinical validation of the technique. Anesthesiology 1989 ; 70 : 47-50.
- Platell CF, Hall J, Clarke G, Lawrence-Brown M. Intra- abdominal pressure and renal function after surgery to the abdominal aorta. Aust N S J Surg 1990 ; 60 : 213-6.
- Cullen DJ, Coyle JP, Teplick R, Long MC. Cardiovascular, pulmonary, and renal effects of massively increased intra- abdominal pressure in critically ill patients. Crit Care Med 1989 ; 17 : 118-21.
- Smith JH, Merrell RC, Raffin TA. Reversal of postoperative anuria by decompressive celiotomy. Arch Intern Med 1985 ; 145 : 553-4.
- O = stlund RE, Sta/ ten M, Kohrt WM, Shultz J, Malley M. The ratio of waist-to-hip circumference, plasma insulin level and glucose intolerance as independent predictors of HDL # -chol- esterol level in older adults. N Engl J Med 1990 ; 322 : 229-34.
- Kvist H, Chowdhury B, Granga/ rd U, Tyle! n U, Sjo$ stro$ m L. Total and visceral adipose-tissue volumes derived from measure- ments with computed tomography in adult men and women : predictive equations. Am J Clin Nutr 1988 ; 48 : 1351-61. 27 Sjo$ stro$ m L. A computer-tomography based multicompartment body composition technique and anthropometric predictions of lean body mass, total and subcutaneous adipose tissue. Int J Obes 1991 ; 15(Suppl. 2) : 19-30.
- Sugerman HJ, Fairman RP, Sood RK, Engle K, Wolfe L, Kellum JM. Long-term effects of gastric bypass surgery for treating respiratory insufficiency of obesity. Am J Clin Nutr 1992 ; 55 : 597S-601S.
- Mutoh T, Lamm WJE, Embree LJ, Hildebrandt J, Albert RK. Abdominal distension alters regional pleural pressures and chest wall mechanics in pigs in vivo. J Appl Physiol 1991 ; 70 : 2611-8.
- Bloomfield GL, Blocher CR, Fahkry IF, Sica DA, Sugerman HJ. Elevated intraabdominal pressure upregulates the renin- angiotensin-aldosterone system. J Trauma 1996 ; 40 : 193 (abstract).
- Weisinger JR, Kempson RL, Eldridge FL, Swenson RS. The nephrotic syndrome : a complication of massive obesity. Ann Intern Med 1974 ; 81 : 440-7.
- Valensi P, Assayag M, Busby M, Paries J, Lormeau B, Attali J- R. Microalbuminuria in obese patients with or without hypertension. Int J Obesity Related Metabol Disorders 1996 ; 20 : 574-9.
- Foley RF, Benotti PN, Borlase BC, Hollingshead J, Blackburn GL. Impact of gastric restrictive surgery on hypertension in the morbidly obese. Am J Surg 1992 ; 163 : 294-7.
- Carson JL, Ruddy ME, Duff AE, Holmes NJ, Cody RP, Brolin RE. The effect of gastric bypass surgery on hypertension in morbidly obese patients. Arch Int Med 1994 ; 154 : 193-200.
- Diebel LN, Wilson RF, Dulchavsky SA, Saxe J. Effect of increased intraabdominal pressure on hepatic arterial, portal venous, and hepatic microcirculatory blood flow. J Trauma 1992 ; 33 : 279-82.
- Sugerman HJ, Felton WL, Sismanis A, Salvant JB, Kellum JM. Effects of surgically induced weight loss on pseudotumor cerebri in morbid obesity. Neurology 1995 ; 45 : 1655-9.
- Josephs LG, Este-McDonald JR, Birkett DH, Hirsch EF. Di- agnostic laparoscopy increases intracranial pressure. J Trauma 1994 ; 36 : 815-9.
- Bloomfield GL, Ridings PC, Blocher CS, Marmarou A, Suger- man HJ. Effects of increased intraabdominal pressure upon intracranial and cerebral perfusion pressure before and after volume expansion. J Trauma 1996 ; 40 : 936-43.
- Bloomfield GL, Ridings PC, Blocher CR, Sugerman HJ. In- creased pleural pressure mediates the effects of elevated intraabdominal pressure upon the central nervous and car- diovascular systems. Crit Care Med (in press).
Cited by
Sorted by citations
Bariatric Surgery: A Systematic Review and Meta-analysis
Buchwald, H., Avidor, Y., Braunwald, E., Jensen, M. D., Pories, W., Fahrbach, K., & Schoelles, K. (2004) · JAMA · doi:10.1001/jama.292.14.1724 · Cited by 6,800 · see citing works
Malbrain, M. L. N. G., Cheatham, M. L., Kirkpatrick, A. W., Sugrue, M., Parr, M. J., Waele, J. J. D., Balogh, Z. J., Leppäniemi, A. K., Olvera, C., Ivatury, R. R., et al. (2006) · Intensive Care Medicine · doi:10.1007/s00134-006-0349-5 · Cited by 1,524 · see citing works
“associated with chronic IAP elevations of 10–15 mmHg to which the patient has adapted with an absence of significant pathophysiology [70, 71, 72, 73, 74, 75, 76, 77].”
BackgroundObesity-Induced Hypertension: Interaction of Neurohumoral and Renal Mechanisms
Hall, J. E., do Carmo, J. M., da Silva, A. A., Wang, Z., & Hall, M. E. (2015) · Circulation Research · doi:10.1161/circresaha.116.305697 · Cited by 1,360 · see citing works
European Resuscitation Council Guidelines for Resuscitation 2015
Perkins, G. D., Handley, A. J., Koster, R. W., Castrén, M. K., Smyth, M. A., Olasveengen, T. M., Monsieurs, K. G., Raffay, V. I., Gräsner, J., Wenzel, V., et al. (2015) · Resuscitation · doi:10.1016/j.resuscitation.2015.07.015 · Cited by 1,287 · see citing works
The effect of obesity on lung function
Dixon, A. E., & Peters, U. (2018) · Expert Review of Respiratory Medicine · doi:10.1080/17476348.2018.1506331 · Cited by 889 · see citing works
The Kidney, Hypertension, and Obesity
Hall, J. E. (2003) · Hypertension · doi:10.1161/01.hyp.0000052314.95497.78 · Cited by 868 · see citing works
European Resuscitation Council Guidelines for Resuscitation 2015
Truhlář, A., Deakin, C. D., Soar, J., Khalifa, G. E. A., Alfonzo, A. V. M., Bierens, J. J. L. M., Brattebø, G., Brugger, H., Dunning, J., Hunyadi-Antičević, S., et al. (2015) · Resuscitation · doi:10.1016/j.resuscitation.2015.07.017 · Cited by 812 · see citing works
Central obesity and increased risk of dementia more than three decades later
Whitmer, R. A., Gustafson, D. R., Barrett-Connor, E., Haan, M. N., Gunderson, E. P., & Yaffe, K. (2008) · Neurology · doi:10.1212/01.wnl.0000306313.89165.ef · Cited by 803 · see citing works
European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances
Lott, C., Truhlář, A., Alfonzo, A. V. M., Barelli, A., Salvado, V. G., Hinkelbein, J., Nolan, J. P., Paal, P., Perkins, G. D., Thies, K., et al. (2021) · Resuscitation · doi:10.1016/j.resuscitation.2021.02.011 · Cited by 818 · see citing works
Malbrain, M. L. N. G., Chiumello, D., Pelosi, P. P., Bihari, D. J., Innes, R., Ranieri, V. M., Turco, M. D., Wilmer, A. P., Brienza, N., Malcangi, V., et al. (2005) · Critical Care Medicine · doi:10.1097/01.ccm.0000153408.09806.1b · Cited by 734 · see citing works
Obesity, kidney dysfunction and hypertension: mechanistic links
Hall, J. E., do Carmo, J. M., da Silva, A. A., Wang, Z., & Hall, M. E. (2019) · Nature Reviews Nephrology · doi:10.1038/s41581-019-0145-4 · Cited by 654 · see citing works
Obesity: A Challenge to Esophagogastric Junction Integrity
Pandolfino, J. E., El‐Serag, H. B., Zhang, Q., Shah, N. K., Ghosh, S. K., & Kahrilas, P. J. (2006) · Gastroenterology · doi:10.1053/j.gastro.2005.12.016 · Cited by 556 · see citing works
Intra-abdominal Pressure in the Intensive Care Unit: Clinical Tool or Toy?
Malbrain, M. L. N. G. (2001) · Springer eBooks · doi:10.1007/978-3-642-59467-0_46 · Cited by 529 · see citing works
Obesity, hypertension, and chronic kidney disease
Hall, J., Juncos, L., Wang, Z., Hall, M., do Carmo, J., & da Silva, A. (2014) · International Journal of Nephrology and Renovascular Disease · doi:10.2147/ijnrd.s39739 · Cited by 520 · see citing works
Obesity and Obesity-Initiated Metabolic Syndrome
Wahba, I. M., & MAK, R. H. K. (2007) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.04071206 · Cited by 518 · see citing works
Diabetes and Hypertension in Severe Obesity and Effects of Gastric Bypass-Induced Weight Loss
Sugerman, H. J., Wolfe, L. G., Sica, D. A., & Clore, J. N. (2003) · Annals of Surgery · doi:10.1097/01.sla.0000071560.76194.11 · Cited by 499 · see citing works
Self-citationNormal Intraabdominal Pressure in Healthy Adults
Cobb, W. S., Burns, J. M., Kercher, K. W., Matthews, B. D., Norton, H. J., & Heniford, B. T. (2005) · Journal of Surgical Research · doi:10.1016/j.jss.2005.06.015 · Cited by 462 · see citing works
Sex Disparities in Cancer Incidence by Period and Age
Cook, M. B., Dawsey, S. M., Freedman, N. D., Inskip, P. D., Wichner, S. M., Quraishi, S. M., Devesa, S. S., & McGlynn, K. A. (2009) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-08-1118 · Cited by 460 · see citing works
“Putative differences between the sexes that may explain the male predominance of esophageal adenocarcinoma include android obesity (32), production and concentration of gastric acid (33), hiatal hernia (34), defective lower esophageal sphincter (34), and higher intra-abdominal and intragastric pressures (35).”
BackgroundMechanick, J. I., Kushner, R. F., Sugerman, H. J., González-Campoy, J. M., Collazo–Clavell, M. L., Guven, S., Spitz, A. F., Apovian, C. M., Livingston, E. H., Brolin, R. E., et al. (2008) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2008.08.009 · Cited by 372 · see citing works
“[109] Sugerman H, Windsor A, Bessos M, Wolfe L.”
BackgroundSelf-citationMechanisms of Obesity-Associated Cardiovascular and Renal Disease
Hall, J. E., Crook, E. D., Jones, D. W., Wofford, M. R., & Dubbert, P. M. (2002) · The American Journal of the Medical Sciences · doi:10.1097/00000441-200209000-00003 · Cited by 373 · see citing works
Role of Hyperinsulinemia and Insulin Resistance in Hypertension: Metabolic Syndrome Revisited
da Silva, A. A., do Carmo, J. M., Li, X., Wang, Z., Mouton, A. J., & Hall, J. E. (2020) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2020.02.066 · Cited by 381 · see citing works
Keulenaer, B. L. D., Waele, J. J. D., Powell, B., et al. (2009) · Intensive Care Medicine · doi:10.1007/s00134-009-1445-0 · Cited by 351 · see citing works
“[31, 34, 35] reported a positive correlation between bladder pressures and the sagittal abdominal diameter (SAD) and found that surgical patients with a mean BMI of 52 ± 1 kg/m(2) had an IAP of 13.”
BackgroundMechanick, J. I., Kushner, R. F., Sugerman, H. J., González-Campoy, J. M., Collazo–Clavell, M. L., Spitz, A. F., Apovian, C. M., Livingston, E. H., Brolin, R. E., Sarwer, D. B., et al. (2009) · Obesity · doi:10.1038/oby.2009.28 · Cited by 338 · see citing works
Self-citationAbdominal Compartment Syndrome
Saggi, B. H., Sugerman, H. J., Ivatury, R. R., & Bloomfield, G. L. (1998) · doi:10.1097/00005373-199809000-00033 · Cited by 332 · see citing works
Self-citationMontani, J.-P., Carroll, J. F., Dwyer, T. M., Antic, V., Yang, Z., & Dulloo, A. G. (2004) · International Journal of Obesity · doi:10.1038/sj.ijo.0802858 · Cited by 294 · see citing works
“Furthermore, intra-abdominal pressure, which is directly related to the degree of abdominal adiposity”
BackgroundObesity increases oesophageal acid exposure
El‐Serag, H. B., Ergun, G. A., Pandolfino, J. E., et al. (2006) · Gut · doi:10.1136/gut.2006.100263 · Cited by 292 · see citing works
Obesity and hypertension: two epidemics or one?
Davy, K. P., & Hall, J. E. (2004) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00707.2003 · Cited by 280 · see citing works
“Intra-abdominal pressure is directly related to the degree of abdominal adiposity (148), and, thus, elevated intra-abdominal fat could act to compress the kidney, increase sodium and water retention, and elevate BP (19, 20).”
BackgroundWhat is Normal Intra-Abdominal Pressure?
Sanchez, N. C., Tenofsky, P. L., Dort, J. M., Shen, L. Y., Helmer, S. D., & Smith, R. S. (2001) · The American Surgeon · doi:10.1177/000313480106700308 · Cited by 279 · see citing works
AGA technical review on obesity
Klein, S., Wadden, T., & Sugerman, H. J. (2002) · Gastroenterology · doi:10.1053/gast.2002.35514 · Cited by 274 · see citing works
Self-citationRespiratory restriction and elevated pleural and esophageal pressures in morbid obesity
Behazin, N., Jones, S. B., Cohen, R., & Loring, S. H. (2009) · Journal of Applied Physiology · doi:10.1152/japplphysiol.91356.2008 · Cited by 272 · see citing works
Effect of Increased Renal Venous Pressure on Renal Function
Doty, J. M., Saggi, B. H., Sugerman, H. J., Blocher, C. R., Pin, R. J. A., Fakhry, I., Gehr, T. W. B., & Sica, D. A. (1999) · doi:10.1097/00005373-199912000-00002 · Cited by 268 · see citing works
Self-citationIs obesity a major cause of chronic kidney disease?
Hall, J. E., Henegar, J. R., Dwyer, T. M., Liu, J., da Silva, A. A., Kuo, J. J., & Tallam, L. (2004) · Advances in Renal Replacement Therapy · doi:10.1053/j.arrt.2003.10.007 · Cited by 264 · see citing works
Intra-abdominal hypertension in the critically ill: it is time to pay attention
Malbrain, M. L. N. G., Deeren, D., & Potter, T. J. R. D. (2005) · Current Opinion in Critical Care · doi:10.1097/01.ccx.0000155355.86241.1b · Cited by 258 · see citing works
Sapala, J. A., Wood, M. H., Schuhknecht, M. P., et al. (2003) · Obesity Surgery · doi:10.1381/096089203322618588 · Cited by 261 · see citing works
Pulmonary Function and Abdominal Adiposity in the General Population
Ochs‐Balcom, H. M., Grant, B. J. B., Muti, P. C., Sempos, C. T., Freudenheim, J. L., Trevisan, M., Cassano, P. A., Iacoviello, L., & Schünemann, H. J. (2006) · CHEST Journal · doi:10.1378/chest.129.4.853 · Cited by 252 · see citing works
Obesity and the lung: 1 {middle dot} Epidemiology
McClean, K., Kee, F., Young, I. S., & Elborn, J. S. (2008) · Thorax · doi:10.1136/thx.2007.086801 · Cited by 243 · see citing works
Hypertension: Physiology and Pathophysiology
Hall, J. E., Granger, J. P., do Carmo, J. M., da Silva, A. A., Dubinion, J., George, E., Hamza, S., Speed, J., & Hall, M. E. (2012) · Comprehensive Physiology · doi:10.1002/cphy.c110058 · Cited by 232 · see citing works
Gastric Surgery for Pseudotumor Cerebri Associated With Severe Obesity
Sugerman, H. J., Felton, W. L., Sismanis, A. A., Kellum, J. M., DeMaria, E. J., & Sugerman, E. L. (1999) · Annals of Surgery · doi:10.1097/00000658-199905000-00005 · Cited by 226 · see citing works
Self-citationThe Impact of Obesity on Outcome after Major Colorectal Surgery
Gendall, K. A., Raniga, S., Kennedy, R., & Frizelle, F. (2007) · Diseases of the Colon & Rectum · doi:10.1007/s10350-007-9051-0 · Cited by 221 · see citing works
EFFECTS OF INCREASED INTRA-ABDOMINAL PRESSURE IN SEVERE OBESITY
Sugerman, H. J. (2001) · Surgical Clinics of North America · doi:10.1016/s0039-6109(05)70184-5 · Cited by 218 · see citing works
Self-citationAneja, A. (2004) · Recent Progress in Hormone Research · doi:10.1210/rp.59.1.169 · Cited by 217 · see citing works
Risks and Benefits of Gastric Bypass in Morbidly Obese Patients With Severe Venous Stasis Disease
Sugerman, H. J., Sugerman, E. L., Wolfe, L. G., Kellum, J. M., Schweitzer, M. A., & DeMaria, E. J. (2001) · Annals of Surgery · doi:10.1097/00000658-200107000-00007 · Cited by 202 · see citing works
Self-citationObesity Correlates with Gastroesophageal Reflux
Fisher, B. L., Pennathur, A., Mutnick, J. L. M., & Little, A. G. (1999) · Digestive Diseases and Sciences · doi:10.1023/a:1026617106755 · Cited by 198 · see citing works
Intra-abdominal hypertension and the abdominal compartment syndrome
Schein, M., & Ivatury, R. R. (1998) · British journal of surgery · doi:10.1046/j.1365-2168.1998.00831.x · Cited by 195 · see citing works
Mechanick, J. I., Kushner, R. F., Sugerman, H. J., González-Campoy, J. M., Collazo–Clavell, M. L., Guven, S., Spitz, A. F., Apovian, C. M., Livingston, E. H., Brolin, R. E., et al. (2008) · Endocrine Practice · doi:10.4158/ep.14.s1.1 · Cited by 193 · see citing works
“[109] Sugerman H, Windsor A, Bessos M, Wolfe L.”
BackgroundSelf-citationThe metabolic syndrome and chronic kidney disease
Zhang, X., & Lerman, L. O. (2016) · Translational research · doi:10.1016/j.trsl.2016.12.004 · Cited by 177 · see citing works
Karason, K., Lindroos, A. K., Stenlöf, K., & Sjöström, L. (2000) · Archives of Internal Medicine · doi:10.1001/archinte.160.12.1797 · Cited by 168 · see citing works
“Furthermore, the elevation in intra-abdominal pressure associated with visceral adiposity predisposes subjects to gastroesophageal reflux and symptoms of heartburn.(31,32) Finally, obstructive sleep apnea has been reported to simulate angina pectoris even in the absence of coronary atherosclerosis.”
BackgroundImpact of obesity on venous hemodynamics of the lower limbs
Willenberg, T., Schumacher, A., Amann-Vesti, B. R., Jacomella, V., Thalhammer, C., Diehm, N., Baumgärtner, I., & Husmann, M. J. W. (2010) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2010.04.023 · Cited by 169 · see citing works
“There are invasive human in-vivo studies that investigated the effect of abdominal obesity on IAP and intravenous iliac pressure.(8,9) These studies required either a venous access or a bladder catheter.”
BackgroundHong, J. J., Cohn, S. M., Perez, J. M., Dolich, M. O., Brown, M., & McKenney, M. G. (2002) · British journal of surgery · doi:10.1046/j.1365-2168.2002.02072.x · Cited by 154 · see citing works
The Influence of Obesity on Chronic Venous Disease
Daníelsson, G., Eklöf, B., Grandinetti, A., & Kistner, R. L. (2002) · Vascular and Endovascular Surgery · doi:10.1177/153857440203600404 · Cited by 158 · see citing works
Effects of Increased Renal Parenchymal Pressure on Renal Function
Doty, J. M., Saggi, B. H., Blocher, C. R., et al. (2000) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/00005373-200005000-00010 · Cited by 155 · see citing works
Self-citationUrinary Stress Incontinence Among Obese Women: Review of Pathophysiology Therapy
Cummings, J. M., & Rodning, C. (2000) · International Urogynecology Journal · doi:10.1007/s001920050008 · Cited by 154 · see citing works
“measurements. In a study of anesthetized patients about to undergo bariatric procedures, increased sagittal abdominal diameter was associated with elevated intraabdominal and intravesical pressures compared to nonobese patients scheduled to undergo colectomy for ulcerative colitis [ 16 ].”
BackgroundETIOLOGY AND PATHOPHYSIOLOGY OF PRIMARY AND RECURRENT GROIN HERNIA FORMATION
Abrahamson, J. (1998) · Surgical Clinics of North America · doi:10.1016/s0039-6109(05)70364-9 · Cited by 149 · see citing works
Obesity and Impaired Venous Function
van Rij, A. M., Alwis, C. S. D., Jiang, P., et al. (2008) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2008.01.006 · Cited by 140 · see citing works
Groot, N., Burgerhart, J. S., van de Meeberg, P. C., de Vries, D. R., Smout, A. J. P. M., & Siersema, P. D. (2009) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2009.04146.x · Cited by 138 · see citing works
The surgical treatment of morbid obesity
Kellum, J. M., DeMaria, E. J., & Sugerman, H. J. (1998) · Current Problems in Surgery · doi:10.1016/s0011-3840(98)80009-9 · Cited by 137 · see citing works
Self-citationLaparoscopic Ventral Hernia Repair in Obese Patients
Novitsky, Y. W. (2006) · Archives of Surgery · doi:10.1001/archsurg.141.1.57 · Cited by 133 · see citing works
Metabolic syndrome and urologic diseases.
Gorbachinsky, I., Akpınar, H., & Assimos, D. G. (2010) · Europe PMC (PubMed Central) · Cited by 132 · see citing works
Thrombosis in central obesity and metabolic syndrome: Mechanisms and epidemiology
Morange, P., & Alessi, M. (2013) · Thrombosis and Haemostasis · doi:10.1160/th13-01-0075 · Cited by 132 · see citing works
“Central obesity is associated with raised intra-abdominal pressure and reduced venous blood flow velocity, which may render blood more susceptible to thrombosis (151, 152).”
BackgroundKral, J. G. (2001) · Surgical Clinics of North America · doi:10.1016/s0039-6109(05)70183-3 · Cited by 129 · see citing works
Obesity-hypertension: an ongoing pandemic
Francischetti, E. A., & Genelhu, V. A. (2007) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2006.01262.x · Cited by 130 · see citing works
Obesity and Pelvic Floor Disorders
Greer, W. J., Richter, H. E., Bartolucci, A. A., & Burgio, K. L. (2008) · Obstetrics and Gynecology · doi:10.1097/aog.0b013e31817cfdde · Cited by 125 · see citing works
Urinary and Anal Incontinence in Morbidly Obese Women Considering Weight Loss Surgery
Richter, H. E., Burgio, K. L., Clements, R. H., Goode, P. S., Redden, D. T., & Varner, R. E. (2005) · Obstetrics and Gynecology · doi:10.1097/01.aog.0000187299.75024.c4 · Cited by 122 · see citing works
Abdominal compartment syndrome.
Bailey, J. A., & Shapiro, M. J. (2000) · Critical Care · doi:10.1186/cc646 · Cited by 124 · see citing works
“Abdominal decompression and weight loss via bariatric surgery have been shown to reverse benign ICP associated with IAH [9,27].”
BackgroundNguyen, N. T., Perez, R. V., Fleming, N., et al. (2002) · Journal of the American College of Surgeons · doi:10.1016/s1072-7515(02)01321-2 · Cited by 122 · see citing works
Correlations between intra-abdominal pressure and obesity-related co-morbidities
Varela, J. E., Hinojosa, M. W., & Nguyen, N. T. (2009) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2009.04.003 · Cited by 118 · see citing works
Paolini, J.-B. M., Mancini, J., Genestal, M., Gonzalez, H., McKay, R. E., Samii, K., & Fourcade, O. A. (2010) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181d8cd8b · Cited by 115 · see citing works
“Some authors have shown that a high SAD is associated with a higher urinary bladder pressure, which could predispose to the acute compartment syndrome (44).”
BackgroundLong‐term Results of Polyglactin Mesh for the Prevention of Incisional Hernias in Obese Patients
Pans, A., Elen, P., Dewé, W., et al. (1998) · World Journal of Surgery · doi:10.1007/s002689900420 · Cited by 112 · see citing works
Venous Hypertension, Inflammation and Valve Remodeling
Takase, S., Pascarella, L., Lerond, L., Bergan, J. J., & Schmid-Schönbein, G. W. (2004) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2004.05.012 · Cited by 111 · see citing works
Surveyed Opinion of American Trauma Surgeons on the Prevention of the Abdominal Compartment Syndrome
Mayberry, J. C., Goldman, R. K., Mullins, R. J., et al. (1999) · doi:10.1097/00005373-199909000-00012 · Cited by 111 · see citing works
BMI, Waist Circumference, and Incident Urinary Incontinence in Older Women
Townsend, M. K., Curhan, G. C., Resnick, N. M., & Grodstein, F. (2008) · Obesity · doi:10.1038/oby.2008.14 · Cited by 111 · see citing works
Malbrain, M. L. N. G., laet, I. D., & Cheatham, M. L. (2007) · Acta Clinica Belgica · doi:10.1179/acb.2007.62.s1.007 · Cited by 110 · see citing works
“For example, it has been demonstrated that increased sagittal abdominal diameter in morbidly obese patients is associated with elevated IAP in the absence of other signifi cant pathophysiology (17).”
BackgroundElevated Body Mass Disrupts the Barrier to Gastroesophageal Reflux
Wajed, S. (2001) · Archives of Surgery · doi:10.1001/archsurg.136.9.1014 · Cited by 109 · see citing works
“Obese individuals have a higher intra-abdominal resting pressure, and this relates to the sagittal abdominal diameter.(14) Excess fat deposition in and around abdominal viscera, in addition to elevating intra-abdominal pressure, may interfere with and delay gastric emptying.”
BackgroundIntra-abdominal hypertension and the abdominal compartment syndrome
MOORE, A., Hargest, R., Martin, M., et al. (2004) · British journal of surgery · doi:10.1002/bjs.4703 · Cited by 108 · see citing works
Surgical Management of Obesity: A Review of the Evidence Relating to the Health Benefits and Risks
Lara, M. D., Kothari, S. N., & Sugerman, H. J. (2005) · Treatments in Endocrinology · doi:10.2165/00024677-200504010-00006 · Cited by 107 · see citing works
Self-citationPotoczna, N., Branson, R., Kral, J. G., Piec, G., Steffen, R., Ricklin, T. P., Hoehe, M. R., Lentes, K., & Horber, F. (2004) · Journal of Gastrointestinal Surgery · doi:10.1016/j.gassur.2004.09.032 · Cited by 103 · see citing works
Exploring the pathogenesis of IIH: An inflammatory perspective
Sinclair, A. J., Ball, A. K., Burdon, M., Clarke, C. E., Stewart, P. M., Curnow, J., & Rauz, S. (2008) · Journal of Neuroimmunology · doi:10.1016/j.jneuroim.2008.06.029 · Cited by 104 · see citing works
“This theory does not explain why despite ubiquitous elevation of intra-abdominal pressure in obese patients (Sugerman et al., 1997; Whiteley et al., 2006), only a small proportion of patients develop IIH.”
BackgroundThe polycompartment syndrome: a concise state-of-the-art review
Malbrain, M. L. N. G., Roberts, D. J., Sugrue, M., Keulenaer, B. L. D., Ivatury, R. R., Pelosi, P. P., Verbrugge, F. H., Wise, R., & Müllens, W. (2014) · Anestezjologia, Intensywna Terapia · doi:10.5603/ait.2014.0064 · Cited by 103 · see citing works
Obesity and lower limb venous disease – The epidemic of phlebesity
Davies, H., Popplewell, M. A., Singhal, R., Smith, N., & Bradbury, A. W. (2016) · Phlebology The Journal of Venous Disease · doi:10.1177/0268355516649333 · Cited by 100 · see citing works
Venous thromboembolism has the same risk factors as atherosclerosis
Mi, Y., Yan, S., Lu, Y., Liang, Y., & Li, C. (2016) · Medicine · doi:10.1097/md.0000000000004495 · Cited by 102 · see citing works
Increased Intraabdominal Pressure in Abdominoplasty: Delineation of Risk Factors
Huang, G. J., Bajaj, A. K., Gupta, S. C., et al. (2007) · Plastic & Reconstructive Surgery · doi:10.1097/01.prs.0000254529.51696.43 · Cited by 101 · see citing works
Abdominal pressure in the critically ill
Malbrain, M. L. N. G. (2000) · Current Opinion in Critical Care · doi:10.1097/00075198-200002000-00003 · Cited by 100 · see citing works
Bariatric surgery and progression of chronic kidney disease.
Navaneethan, S., & Yehnert, H. (2009) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2009.01.006 · Cited by 95 · see citing works
Menzo, E. L., Hinojosa, M. W., Carbonell, A. M., Krpata, D. M., Carter, J. T., & Rogers, A. M. (2018) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2018.07.005 · Cited by 98 · see citing works
Clinical Approach to the Critically Ill, Morbidly Obese Patient
El-Solh, A. (2004) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200309-1256cc · Cited by 98 · see citing works
“Multiple trauma, massive hemorrhage, and protracted surgical operations with extraordinary volume resuscitation are the situations in which this syndrome is most frequently encountered (24).”
BackgroundAbdominal compartment syndrome in the intensive care unit
Morken, J. J., & West, M. A. (2001) · Current Opinion in Critical Care · doi:10.1097/00075198-200108000-00010 · Cited by 98 · see citing works
Malbrain, M. L. N. G., laet, I. D., Waele, J. J. D., et al. (2014) · Anestezjologia, Intensywna Terapia · doi:10.5603/ait.2014.0063 · Cited by 95 · see citing works
Multisystem organ failure secondary to increased intraabdominal pressure
Sugerman, H. J., Bloomfield, G. L., & Saggi, B. (1999) · Infection · doi:10.1007/bf02565176 · Cited by 94 · see citing works
Self-citationIntra-Abdominal Hypertension: Evolving Concepts
Malbrain, M. L. N. G., & laet, I. E. D. (2009) · Clinics in Chest Medicine · doi:10.1016/j.ccm.2008.09.003 · Cited by 88 · see citing works
Obesity and Stress Urinary Incontinence: Impact on Pathophysiology and Treatment
Fuselier, A., Hanberry, J., Lovin, J. M., & Gomelsky, A. (2018) · Current Urology Reports · doi:10.1007/s11934-018-0762-7 · Cited by 86 · see citing works
RATIONAL INTRAABDOMINAL PRESSURE MONITORING: HOW TO DO IT?
Waele, J. J. D., laet, I. D., & Malbrain, M. L. N. G. (2007) · Acta Clinica Belgica · doi:10.1179/acb.2007.62.s1.004 · Cited by 86 · see citing works
“Related to diminished abdominal wall compliance − Mechanical ventilation, especially fi ghting with the ventilator and the use of accessory muscles (47, 48) − Use of positive end expiratory pressure (PEEP) or the presence of auto-PEEP (49-51) − Basal pleuroneumonia − High body mass index (40, 52-55) − Pneumoperitoneum…”
BackgroundThe neglected role of abdominal compliance in organ-organ interactions
Malbrain, M. L. N. G., Peeters, Y., & Wise, R. (2016) · Critical Care · doi:10.1186/s13054-016-1220-x · Cited by 86 · see citing works
“Morbidly obese patients with an android (mainly visceral and sphere shaped) fat distribution have a limited reserve to accommodate excess IAV than those patients who, for a similar BMI or abdominal perimeter, have a gynoid (mainly subcutaneous and ellipse shaped) fat distribution [17, 29].”
BackgroundThe Effect of Obesity Surgery on Obesity Comorbidity
Bouldin, M. J., Ross, L. A., Sumrall, C. D., Loustalot, F. V., Low, A. K., & Land, K. K. (2006) · The American Journal of the Medical Sciences · doi:10.1097/00000441-200604000-00004 · Cited by 85 · see citing works
Malbrain, M., Roberts, D., Laet, I. D. D., Waele, J. D., Sugrue, M., Schachtrupp, A., Duchesne, J., van Ramshorst, G. V., Keulenaer, B. D. D., Kirkpatrick, A., et al. (2014) · Anaesthesiology Intensive Therapy · doi:10.5603/ait.2014.0062 · Cited by 73 · see citing works
Regueira, T., Bruhn, A., Hasbun, P., Aguirre, M., Romero, C., Llanos, O., Castro, R., Bugedo, G., & Hernandez, G. (2008) · Journal of Critical Care · doi:10.1016/j.jcrc.2007.12.013 · Cited by 84 · see citing works
“Previous studies on IAH have focused mainly on trauma [14-16], surgical [17-19], burned [20], and obese [16] patients, and an elevated prevalence of IAH has also been reported in sepsis [21].”
BackgroundSleep and Nocturnal Gastroesophageal Reflux
Lim, K. G., Morgenthaler, T. I., & Katzka, D. A. (2018) · CHEST Journal · doi:10.1016/j.chest.2018.05.030 · Cited by 84 · see citing works
El-Atat, F. A., Aneja, A., McFarlane, S. I., & Sowers, J. R. (2003) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/s0889-8529(03)00070-7 · Cited by 82 · see citing works
Carlsson, L. M. S., Romeo, S., Jacobson, P., Burza, M. A., Maglio, C., Sjöholm, K., Svensson, P., Haraldsson, B. S., Peltonen, M., & Sjöström, L. (2014) · International Journal of Obesity · doi:10.1038/ijo.2014.72 · Cited by 82 · see citing works
Zaidi, E., & Daly, B. (2006) · American Journal of Roentgenology · doi:10.2214/ajr.05.0033 · Cited by 81 · see citing works
“This measurement has been used as an index of abdominal obesity in prior studies [14–16].”
MethodBlaser, A. R., Björck, M., Keulenaer, B. L. D., & Regli, A. (2015) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0000000000000616 · Cited by 79 · see citing works
“Monitoring of IAP at the time of abdominal closure and in the first days after abdominal closure is advisable in patients with decreased AC.”
BackgroundInfluential
- Authors
- SUGERMAN, H., WINDSOR, A., BESSOS, M., & WOLFE, L.
- Affiliations
- Virginia Commonwealth University (US)
- Corresponding author
- SUGERMAN, H.
- ORCID
- WINDSOR, A.
- Venue
- Journal of Internal Medicine
- Publisher
- Wiley
- Published
- 1997-01
- Volume
- 241
- Issue
- 1
- Pages
- 71-79
- ISSN
- 0954-6820 (ISSN-L)
- 1365-2796
- OpenAlex
- W1976707172
- Cited by
- 486
- References
- 0
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 13 · 2023: 15 · 2022: 9 · 2021: 25 · 2020: 14 · 2019: 16 · 2018: 19 · 2017: 18 · 2016: 20 · 2015: 30 · 2014: 19 · 2013: 16 · 2012: 21
- FWCI
- 11.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Abdominal Surgery and Complications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- intra-abdominal pressure, sagittal abdominal diameter, obesity-related comorbidities, abdominal obesity, bladder pressure, waist-to-hip ratio, morbid obesity, gastric bypass, ulcerative colitis, colectomy, obesity-related morbidity, sex differences
- MeSH terms
- Abdomen, Adult, Urinary Bladder, Female, Humans, Male, Obesity, Morbid, Prospective Studies
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
