title: Abdominal Problems in Children with Congenital Cardiovascular Abnormalities.
abstract: BACKGROUND
  Congenital cardiovascular abnormality is an important cause of morbidity and mortality in childhood. Both the type of congenital cardiovascular abnormality and cardiopulmonary bypass are responsible for gastrointestinal system problems.
  
  
  OBJECTIVE
  Intra-abdominal problems, such as paralytic ileus, necrotizing enterocolitis, and intestinal perforation, are common in patients who have been operated or who are being followed for congenital cardiovascular abnormalities. Besides the primary congenital cardiovascular abnormalities, ischemia secondary to cardiac catheterization or surgery contributes to the incidence of these problems.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  In this study, we aimed to screen the intra-abdominal problems seen in patients with congenital cardiovascular abnormalities who had undergone surgical or angiographical intervention(s). Patients with congenital cardiovascular abnormalities who had been treated medically or surgically between 2000 and 2014 were analyzed retrospectively in terms of intra-abdominal problems. The patients' demographic data, type of congenital cardiovascular abnormalities, the intervention applied (surgical, angiographic), the incidence of intra-abdominal problem(s), the interventions applied for the intra-abdominal problems, and the results were evaluated.
  
  
  RESULTS
  Fourteen (Group I) of the 76 patients with congenital cardiovascular abnormalities diagnosis were operated due to intra-abdominal problems, and 62 (Group II) were followed-up clinically for intra-abdominal problems. In Group I (10 boys and 4 girls), 11 patients were aged between 0 and 12 months, and three patients were older than 12 months. Group II included 52 patients aged between 0 and 12 months and 10 patients older than 12 months. Cardiovascular surgical interventions had been applied to six patients in Group I and 40 patients in Group II. The most frequent intra-abdominal problems were necrotizing enterocolitis and intestinal perforation in Group I, and paralytic ileus in Group II. Seven of the Group I patients and 22 of the Group II patients died. The patients who died in both groups had more than three congenital cardiovascular abnormalities in the same patient, and 80% of these patients had been operated for congenital cardiovascular abnormalities.
  
  
  CONCLUSIONS
  The gastrointestinal system is involved in important complications experienced by patients with congenital cardiovascular abnormalities. The mortality rate was higher in operated patients due to gastrointestinal complications. Gastrointestinal complications are more frequent in patients with cyanotic anomalies. The presence of more than one congenital cardiovascular abnormality in a patient increased the mortality rate.
authors.affiliation: Department of Pediatric Surgery, Başkent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Lütfi Hakan
authors.initials: LH
authors.lastname: Güney
authors.affiliation: Department of Anesthesiology, Başkent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Coşkun
authors.initials: C
authors.lastname: Araz
authors.affiliation: Department of Cardiovasculer Surgery, Başkent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Deniz Sarp
authors.initials: DS
authors.lastname: Beyazpınar
authors.affiliation: Department of Pediatric Surgery, Başkent University Faculty of Medicine, Ankara, Turkey.
authors.forename: İrfan Serdar
authors.initials: İS
authors.lastname: Arda
authors.affiliation: Department of Pediatric Surgery, Başkent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Esra Elif
authors.initials: EE
authors.lastname: Arslan
authors.affiliation: Department of Pediatric Surgery, Başkent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Akgün
authors.initials: A
authors.lastname: Hiçsönmez
keywords: Abdominal surgery; cardiopulmonary; cardiovascular abnormalities; congenital; intestinal ischemia