Gastrointestinal complications in patients undergoing coronary artery bypass grafting.
OBJECTIVE
Gastrointestinal complications (GICs) such as gastroduodenal ulcer, enterocolitis, and ischemic colitis after coronary artery bypass grafting (CABG) are rare, but are associated with high mortality and morbidity. The present study was performed to detect risk factors and to investigate outcomes following GICs after CABG.


METHODS
Between January 1992 and December 2001, 17 of 549 patients (3.1%) developed GICs after CABG with cardiopulmonary bypass, presenting with gastrointestinal bleeding due to gastroduodenal ulcer, enterocolitis, or ischemic colitis. We conducted a retrospective analysis of these patients.


RESULTS
All patients required emergent treatment for hemorrhage by means of blood transfusion and endoscopic ablation and/or clipping. The following possible predictors of GICs were identified by logistic multivariate analysis: age over 70, diabetes mellitus (particularly insulin-dependent diabetes), history of cerebrovascular disease or history of renal failure and postoperative low output syndrome (LOS).


CONCLUSIONS
Our results suggested that GICs after CABG with cardiopulmonary bypass are rare but can be lethal. Early diagnosis and prompt intervention can be difficult but are potentially life saving for patients in whom GICs develop.
Yoshida
Kazunori
K
Department of Cardiovascular Surgery, Tenri Hospital, Nara, Japan.
Matsumoto
Masahiko
M
Sugita
Takaaki
T
Nishizawa
Junichiro
J
Matsuyama
Katsuhiko
K
Tokuda
Yoshiyuki
Y
Matsuo
Takehiko
T
D000208:Acute Disease; D000368:Aged; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D017091:Colitis, Ischemic / Q000209:etiology*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004760:Enterocolitis / Q000209:etiology*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology*; D010439:Peptic Ulcer Perforation / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors