Intraabdominal Complications after Cardiac Surgery

심장수술후 복부장기의 합병증

  • 김양원 (인제대학교 의과대학 부산 백병원 흉부외과학 교실) ;
  • 조용길 (인제대학교 의과대학 부산 백병원 흉부외과학 교실)
  • Published : 1996.01.01

Abstract

Intraabdominal complications after cardiac surgery are infrequent, but often fatal. From 1985 to 1993, a total of 1241 cardiovascular operations requiring cardiopulmonary by pass were performed at Pusan Paik Hospital. A total of 16 intraabdominal complications occurred, represe ting a 1.3% incidence. Complications included enterocolitis in six, hepatitis in three, gastric bleeding in two, erosive gastritis in one, cholecystitis in one, spleen rupture in one, epididymitis in one, inguinal hernia in one patient. The overall mortality rate was 12.5% (2 of 16). Three of the 16 patients underwent surgical intervention, and one died. We concluded that intraabdominal complications after cardiac surgery are associated with a high mortality rate, so when evidence of an acute abdominal symptom is observed or conservativi medical treatment fails to improve symptoms, prompt early surgical intervention should be performed.

심장수술후 복부장기의 합병증은 드물게 발생하나 발병시에는 높은 사망률을 야기할 수 있다. 1985년부터 1993년까지 인제의대 부속 부산백병 원에서 인공심폐기를 이용하여 수술한심혈관수술 1241례를 대상으로 하였으며 그중 16명이 복부장기의 합병증이 발생하였고 발병률은 1.3 %였다. 대장염이 6례, 간염이 3례, 위장출혈이 2례, 미란성위염이 1례, 담낭염이 1례, 비장파열이 1례, 부고환염이 1례, 서혜부 탈장이 1례 였다. 16례중 2례가 사망하여 전체적인 사망률은 12.5%였다. 16명의 환자중 3명은 복부장기의 합병증 치료를 위해 수술을 시행하였으며 이중 1명이 사망하였다. 심장수술후 복부장기의 합병증은 높은 사망률을 야기하므로 급성복증이 관찰되거나 내과적인 치료를 통해 증상호전이 없으면 적절한 시기에 적극적인 수술적 치료를 필요로 한다.

Keywords

References

  1. Complications in Surgery and Trauma Complications of cardiac surgery and trauma Oldham,H.N.;Greenfield,L.J.
  2. Complications in Surgery and Their Management Complications of surgery of the heart and adjacent great vessels Lepley,D.;Flemma,R.J.;Mullen,D.C.;Hardy,J.D.
  3. Ann. Thorac. Surg. v.51 Prospects for understanding and eliminating the deleterious effects of cardiopulmonary bypass Kirklin,J.K.
  4. Crit Care Med v.20 Circulating endotoxin and tumor necrosis factor during pediatric cardiac surgery Casey,W.F.;Hauser,G.J.;Hannallah,R.S.;Midgley,F.M.;Khan,W.N.
  5. Am. J. Surg. v.149 Hypoperfusion as a possible factor in the development of gastrointestinal complications after cardiac surgery Moneta,G.L.;Misbach,G.A.;Ivey,T.D.
  6. Surg. Gynecol. Obstet. v.165 Intra-abdominal complications of cardiopulmonay bypass operations Leitman,M.I.;Paull,D.E.;Barie,P.S.(et al.)
  7. Am. J. Surg. v.146 General surgical complications after cardiopulmonary bypass surgery Pinson,C.W.;Alberty,R.E.
  8. Am. Surg. v.49 General surgical complications following cardiac surgery Reath,D.B.;Maull,K.I.;Wolfgang,T.C.
  9. Arch. Surg. v.121 Gastrointestinal complications after cardiac surgery Welling,R.E.;Rath.R.;Albers,J.E.;Glaser,R.S.
  10. Surgery v.72 Acute gastrointestinal ulceration with open heart surgery and aortic valve disease Katz,S.E.;Kornfeld,D.S.;Harris,P.D.;Yeoh,C.
  11. Am. J. Surg. v.134 Gastroduodenal perforation after open heart surgery Shockett,E.;Boruchow,I.B.;Rotbart,A.(et al.)
  12. Ann. Surg. v.178 Management of acute stress ulcer after cardiac surgery Taylor,P.C.;Loop,F.D.;Hermann,R.E.
  13. Ann. Surg. v.190 An 11 year evolution of coronary arterial surgery(1967-1978) Loop,F.D.;Cosgrove,D.M.;Lytle,B.W.(et al.)
  14. Am. J. Surg. v.150 Acute posttraumatic acalculous cholecystitis Flancbaum,L.;Majerus,T.C.;Cox,E.F.
  15. Gastroenterology v.80 Gallbladder disease in patient on long-term parenteral nutrition[Abstract] Roslyn,J.J.;Pitt,H.A.;Mann,L.L.(et al.)
  16. Surgery v.104 Gastrointestinal complications after cardiac surgery Krasna,M.J.;Flancbaum,L.;Trooskin,S.Z.(et al.)
  17. Surgery v.92 Gastrointestinal complications after cardiopulmonary bypass Hanks,J.B.;Curtis,S.E.;Hanks,B.B.;Andersen,D.K.;Cox,J.L.;Jones,R.S.