"Round belly sign"

Q: What is the "Round belly sign" on a CT scan in patients with suspicion of intra-abdominal compartment syndrome (IACS)?

Answer: The round-belly sign will be termed positive for IACS if abdominal distention has an increased ratio of anteroposterior-to-transverse abdominal diameter of more than 0.80, with 100% sensitivity and 94% specificity. Setting the value to 0.82 increased specificity to 99%.

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References:

1. Pickhardt PJ, Shimony JS, Heiken JP, Buchman TG, Fisher AJ. The abdominal compartment syndrome: CT findings. AJR 1999;173:575 -579

2. Bouveresse S, Piton G, Delabrousse E. The round belly sign. Abdom Radiol (NY). 2017 Feb;42(2):663-664. doi: 10.1007/s00261-016-0895-4. PMID: 27638514.

3. Lombardi AF, Thompson CP, Zulfiqar M, Jain A, Krishnan I, Sandrasegaran K. Radiologic evaluation of abdominal compartment syndrome: an updated educational review. Abdom Radiol (NY). 2025 Aug 18. doi: 10.1007/s00261-025-05148-8. Epub ahead of print. PMID: 40824534.