Objectif: I~valuer I'incidence, les modalit6s de survenue et I'Evolution des complications digestives apr& chirurgie cardiaque sous circulation extracorporelle (CEC). M&hode : I~tude retrospective sur 6281 aduttes op&& sous CEC entre le I er janvier 1994 et le 31 d&embre 1997. R~..sultats : Soixante patients ont pr6sent6 68 complications digestives (I %) : h6morragie digestive haute (n = 23), isch~mie intestinale (n = 19), chol&ystite aigu~ (n --7), pancrEatite aigu~ (n = 6), dilatation colique ( n = 13). I'incidence de ces complications, faible apr& chirurgie coronaire (0,4 %) ou valvulaire (0,8 %), &ait 61ev& aprEs transplantation cardiaque (6 %) ou chirurgie d'une dissection aortique (9 %). ComparEs ~ une population t6moins, les patients ayant prEsentE une complication digestive avaient un score de Parsonnet plus 61ev6 (29 +_ 15 contre 13 _+ 12 points, P --0,002), &aient plus souvent op&& en urgence (40/60, 66 % contre 1120/6221, 18 %; P = 0,01 ), avaient subi une CEC plus Iongue ( I 14 _+ 66 contre 74 -+ 42 min, P = 0,0 I), et avaient prEsentE plus fr6quem-ent un bas debit cardiaque postop&atoire (45/60, 75 % contre 435/6221,7 %; P = 0,00 I). La mortalit6 globale en presence d'une complication digestive a Et6 de 52 %. Les facteurs associ6s ~ la mortalit6 6talent : survenue d'un sepsis (OR=38,7), survenue d'une insuftisance rEnale (OR=7,9), age > 75 ans (OR= 3,5), ventilation m&anique > 7 jours (OR=2,7), association d'une complication neurologique (OR=3,9). Conclusion : Les complications digestives apr& CEC surviennent chez une population ~. risque. Ces complications s'intEgrent clans un contexte de d6faillance multivisc&ale ~ I'origine d'une mortalitE &v&. Purpose: To determine the incidence, circumstances of occurrence and evolution of gastrointestinal complications after cardiac surgery with extracorporeal circulation (ECC). Methods: Retrospective chart study of gastrointestinal complications in 6,281 patients undergoing ECC between January 1994 and December 1997. Results: Sixty patients developed 68 gastrointestinal complications (1%). Complications included: upper gastrointestinal bleeding (n = 23), intestinal ischemia (n = 19), cholecystitis in --7), pancreatitis (n = 6), and paralytic ileus (n = 16). The incidence of these complications was low after coronary artery (0.4%) or valvular surgery (0.8%) and high after cardiac transplantation (6%) and after surgery for acute aortic dissection (9%). Compared with a control population, patients with gastrointestinal complication had a higher Parsonnet score (29 +_ 15 vs 13 _+ 12 points; P = 0.002), were more frequently operated upon as an emergency (40/60, 66% vs I 120/622 I, 18%; P = 0.01 ), underwent ECC of longer duration (I 14 _+ 66 vs 74 _+ 42 min; P = 0.01 ), and presented more frequently with low cardiac output after surgery (45/60, 75% vs 435/622 I, 7%; P = 0.00 I). The mortality rate after gastrointestinal complications was 52%. The major factor associated with mortality was the occurence of sepsis (OR=38.7). Other factors were: renal failure (OR=7.9...