title: [Upper digestive bleedings after cardiac surgery].
abstract: BACKGROUND
  Upper gastrointestinal haemorrhage (UGH) following cardiac surgery is infrequent with high mortality. The aim of this study is to compare the frequency and outcome of UGH in patients who had undergone open heart surgery at our institution.
  
  
  METHODS
  From January 1994 to December 2005, 1278 cardiac operations were performed. A systematic prophylaxis antiacid was used by antagonists of histaminic receptor (anti-H2, ranitidine 150 mg/12 h) in all patients. The diagnosis was based on clinical symptoms (haematemesis and/or melaena) in the postoperative period and confirmed by fibroscopy. We conducted a retrospective study of these patients.
  
  
  RESULTS
  Only 8 of the 1278 (0,6%) cardiac operations were complicated by UGH. Demographic data were reported in Table 1. The mean interval between surgery and UGH was 10+/-3,7 days (range 5,15 days). Gastro-duodenal ulcer was the most common cause of UGH in 5 patients (62%), ulcero-hemorrhagic eosophagitis was developed in one patient (12,5%), candidosic eosophagitis in one and multiple gastric ulcer in one patient (12,5%). Medical treatment was applied in 6 patients (72%) with successful result. Surgical intervention was necessary in 2 patients (25%). 2 patients had repeat gastrointestinal bleeding. One patient was died; he was recorded as having severe sepsis and multiple organ failure in addition to UGH.
  
  
  CONCLUSIONS
  UGH in patients undergoing heart operation is rare but associated with poor prognosis despite antiacid prophylaxis. These complications occurred in patients who had in postoperative bad hemodynamic conditions.
authors.affiliation: Service de chirurgie cardiovasculaire Hay-Riad, hôpital militaire d'instruction Mohammed-V, 10100 Rabat, Maroc. mahdiaithoussa@yahoo.fr
authors.forename: M
authors.initials: M
authors.lastname: Ait Houssa
authors.forename: C
authors.initials: C
authors.lastname: Selkane
authors.forename: Y
authors.initials: Y
authors.lastname: Moutaki Allah
authors.forename: Y
authors.initials: Y
authors.lastname: Elbekkali
authors.forename: B
authors.initials: B
authors.lastname: Amahzoune
authors.forename: F
authors.initials: F
authors.lastname: Wahid
authors.forename: A
authors.initials: A
authors.lastname: Abdou
authors.forename: M
authors.initials: M
authors.lastname: Bamouss
authors.forename: A
authors.initials: A
authors.lastname: Boulahya
authors.forename: A
authors.initials: A
authors.lastname: Elkirat
authors.forename: M
authors.initials: M
authors.lastname: Drissi
authors.forename: D
authors.initials: D
authors.lastname: Ibat
authors.forename: K
authors.initials: K
authors.lastname: Jabrani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies