Abstract
Severe pancreatic complications following cardiac surgery are rare, but 14 patients with severe pancreatitis have been encountered since 1971. Six of these developed acute fulminating pancreatitis following cardiac surgery and each of these died within 21 days following operation. Seven patients had less severe pancreatitis, resulting in pancreatic abscess formation and five in this group expired. One patient developed a pancreatic pseudocyst following mild acute pancreatitis and expired 4 months later. Although the etiologic mechanisms are unclear, possible factors include: prolonged cardiopulmonary bypass, "the low cardiac output syndrome," and inadequately treated or unrecognized postoperative pancreatitis. The diagnosis is based on physical examination, upper gastrointestinal series, and the abdominal CT scan. Despite aggressive surgical therapy, pancreatitis following cardiopulmonary bypass is an extremely serious condition.
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- CORNISH A. L., McCLELLAN J. T., JOHNSTON D. H. Effects of chlorothiazide on the pancreas. N Engl J Med. 1961 Oct 5;265:673–675. doi: 10.1056/NEJM196110052651403. [DOI] [PubMed] [Google Scholar]
- Chenoweth D. E., Cooper S. W., Hugli T. E., Stewart R. W., Blackstone E. H., Kirklin J. W. Complement activation during cardiopulmonary bypass: evidence for generation of C3a and C5a anaphylatoxins. N Engl J Med. 1981 Feb 26;304(9):497–503. doi: 10.1056/NEJM198102263040901. [DOI] [PubMed] [Google Scholar]
- Hanks J. B., Curtis S. E., Hanks B. B., Andersen D. K., Cox J. L., Jones R. S. Gastrointestinal complications after cardiopulmonary bypass. Surgery. 1982 Aug;92(2):394–400. [PubMed] [Google Scholar]
- Harjola P. T., Siltanen P., Appelqvist P., Laustela E. Abdominal complications after open heart surgery. Ann Chir Gynaecol Fenn. 1968;57(3):272–274. [PubMed] [Google Scholar]
- Hennings B., Jacobson G. Postoperative amylase excretion. A study following thoracic surgery with and without extracorporeal circulation. Ann Clin Res. 1974 Aug;6(4):215–222. [PubMed] [Google Scholar]
- Horn J. K., Ranson J. H., Goldstein I. M., Weissler J., Curatola D., Taylor R., Perez H. D. Evidence of complement catabolism in experimental acute pancreatitis. Am J Pathol. 1980 Oct;101(1):205–216. [PMC free article] [PubMed] [Google Scholar]
- Horton E. H., Murthy S. K., Seal R. M. Haemorrhagic necrosis of small intestine and acute pancreatitis following open-heart surgery. Thorax. 1968 Jul;23(4):438–445. doi: 10.1136/thx.23.4.438. [DOI] [PMC free article] [PubMed] [Google Scholar]
- JOHNSTON D. H., CORNISH A. L. Acute pancreatitis in patients receiving chlorothiazide. J Am Med Assoc. 1959 Aug 22;170(17):2054–2056. doi: 10.1001/jama.1959.03010170016003. [DOI] [PubMed] [Google Scholar]
- Murray W. R., Mittra S., Mittra D., Roberts L. B., Taylor K. M. The amylase-creatinine clearance ratio following cardiopulmonary bypass. J Thorac Cardiovasc Surg. 1981 Aug;82(2):248–253. [PubMed] [Google Scholar]
- Panebianco A. C., Scott S. M., Dart C. H., Jr, Takaro T., Echegaray H. M. Acute pancreatitis following extrorporeal circulation. Ann Thorac Surg. 1970 Jun;9(6):562–568. doi: 10.1016/s0003-4975(10)65551-8. [DOI] [PubMed] [Google Scholar]
- Traverso L. W., Ferrari B. T., Buckberg G. D., Tompkins R. K. Eelvated postoperative renal clearance of amylase without pancreatitis after cardiopulmonary bypass. Am J Surg. 1977 Mar;133(3):298–303. doi: 10.1016/0002-9610(77)90532-3. [DOI] [PubMed] [Google Scholar]
- Warshaw A. L., O'Hara P. J. Susceptibility of the pancreas to ischemic injury in shock. Ann Surg. 1978 Aug;188(2):197–201. doi: 10.1097/00000658-197808000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]