title: Gastrointestinal emergencies in cardiac surgery. A retrospective analysis of 3,724 consecutive patients from a single center.
abstract: OBJECTIVE
  The aim of this study is to retrospectively analyze risk factors, diagnosis and management of gastrointestinal (GI) complications following cardiac operations.
  
  
  METHODS
  Patients who developed GI complications after a cardiac operation were studied. Anesthesia protocols, techniques of cardiac surgery, potential risk factors, complications and medical and surgical interventions were reviewed and analyzed.
  
  
  RESULTS
  Out of 3,724 consecutive patients undergoing heart operations during an 8-year period, 33 patients developed GI complications. Eleven patients developed ischemic colitis, 8 cholecystitis, 6 GI bleeding, 4 liver failures, 3 pancreatitis and 1 esophageal hernia. Patients with GI complications had a lower mean ejection fraction compared to patients not developing these complications (45.1 vs. 49.7%, p < 0.01). Also, patients undergoing an urgent cardiac operation were significantly more likely (3.49 times more likely) to develop GI complications postoperatively. Of the 33 affected patients, 18 were treated conservatively and 15 underwent an emergency exploratory laparotomy. Overall mortality was 12% (4 patients).
  
  
  CONCLUSIONS
  Intestinal ischemia and cholecystitis appear to be the most frequent GI complications associated with cardiac surgery. Risk factors include a low ejection fraction and an urgent cardiac operation. Early recognition and treatment of these complications may reduce mortality.
authors: Department of Surgery, Aretaieio University Hospital, Athens Medical School, University of Athens, Athens, Greece. ianvass@otenet.gr
authors: Ioannis
authors: I
authors: Vassiliou
authors: Emmanouel
authors: E
authors: Papadakis
authors: Nikolaos
authors: N
authors: Arkadopoulos
authors: Kassiani
authors: K
authors: Theodoraki
authors: Athanasios
authors: A
authors: Marinis
authors: Theodosios
authors: T
authors: Theodosopoulos
authors: George
authors: G
authors: Palatianos
authors: Vassilios
authors: V
authors: Smyrniotis
mesh_terms: D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods*; D015331:Cohort Studies; D016001:Confidence Intervals; D004359:Drug Therapy, Combination; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D007813:Laparotomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome