Accuracy of diagnostic laparoscopy for early diagnosis of abdominal complications after cardiac surgery

Hackert, Thilo; Kienle, Peter; Weitz, Jürgen; Werner, Jens; Szabo, Gábor; Hagl, S.; Büchler, Markus W.; Schmidt, Jan

doi:10.1007/s00464-003-9004-1

Cited by 45 publications

(44 citation statements)

References 19 publications

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“…In our own department, the policy has become more aggressive, especially in respiratordependant patients after cardiovascular surgery, in order to reach an early diagnosis. In this setting, laparoscopy, e.g., in a bed-side setting, may gain more importance in the future [27].…”

Section: Discussionmentioning

confidence: 99%

Ischemic colitis—analysis of risk factors for postoperative mortality

Antolovic

Koch

Hinz

et al. 2008

Langenbecks Arch Surg

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Section: Discussionmentioning

confidence: 99%

Ischemic colitis—analysis of risk factors for postoperative mortality

Antolovic

Koch

Hinz

et al. 2008

Langenbecks Arch Surg

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“…Following the detection of these symptoms, measures such as cardiac therapy and diuresis to improve heart function and the intestinal microcirculation environment should be actively performed in patients. At the same time, treatments including fasting, rehydration, cleansing enema, gastrointestinal decompression and the administration of anti-acid drugs should be performed (8). If treatment is not provided in a time-efficient manner, this may lead to bowel perforation, sepsis and shock (16).…”

Section: Discussionmentioning

confidence: 99%

“…Specific diagnostic techniques are also helpful in the diagnosis of perforation and bedside laparoscopy is one such technique that is accurate and minimally invasive. The diagnostic sensitivity of bedside laparoscopy may reach 94% with timely application, therefore bedside laparoscopy should be administered to patients suspected of having severe abdominal injury (8). Operative indications include gastrointestinal tract necrosis, perforation, acute intestinal obstruction and gastrointestinal bleeding, which conservative treatments have no efficacy against.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and treatment of postoperative intestinal perforation in infants and young children with congenital heart disease: A report of three cases

et al. 2018

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Abstract. The aim of the present study was to analyze risk factors of intestinal perforation following surgery for the treatment of congenital heart disease in infants and young children, and to summarize experiences of diagnosis and treatment. A total of 3,270 children, who underwent congenital heart disease surgery under extracorporeal circulation from January 2010 to July 2015, were retrospectively analyzed. Among these children, three (0.09%) developed postoperative intestinal perforation. Primary diseases were Tetralogy of Fallot (two cases) and ventricular septal defect combined with atrial septal defect (one case). The age range of the children was 6-11 months and the weight range was 7.3-8.6 kg. Furthermore, these children underwent radical surgery under general anesthesia and extracorporeal circulation in low temperatures. Abdominal symptoms appeared 4-10 days after surgery, and included poor appetite, abdominal distension, intermittent vomiting, high fever, refractory irritability, crying and shortness of breath. One case was confirmed by routine abdominal puncture and the remaining two were confirmed by the detection of free gas under the diaphragm, as revealed by abdominal X-ray. Following the diagnosis of intestinal perforation, emergency intestinal fistula surgery was performed. At 3-5 days post-surgery, the patients underwent treatment by fasting and intravenously administered parenteral nutrition.

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“…The low rate of morbidity, as well as the easy availability and repeatability of laparoscopy in principle, favor the use in urgent diagnosis for mesenteric ischemia over timeconsuming imaging modalities. Diagnostic laparoscopy reports a high sensitivity (94%) for the correct diagnosis of intra-abdominal complications after major cardiac surgery [5]. Another mode of investigation been described in literature is diagnostic peritoneal lavage.…”

Section: Discussionmentioning

confidence: 99%

A case report of acute mesenteric ischemia post coronary artery bypass graft with concomitant aortic valve replacement

Aimanan¹,

Tan²,

Karupiah³

et al. 2016

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. The incidence of post-cardiac surgery gastrointestinal emergencies ranges between 0.4-2.9% and are often of varying diagnoses. Although acute mesenteric ischemia is infrequent, it represents 10-67% of these complications and carries an overall mortality rate of almost 95% of non-surgically treated patients compared to approximately 57% of surgically treated patients. The high number of mortalities is mainly due to its protean clinical presentations resulting in a delay in diagnosis. Case Report: We report a case of acute mesenteric ischemia in a patient who had undergone coronary artery bypass graft (CABG) with concomitant aortic valve surgery. Progressive abdominal distention and rising lactate level were the features pointed towards diagnosis of mesenteric ischemia in this patient. Based on a literature search and review, we discuss on the pearls and pitfalls in the management of this case; with aim to improve the outcome of such similar case in future. Conclusion:Gastrointestinal complications post cardiac surgery should be treated aggressively. Routine utilization of risk assessment tools such as GICS scoring model; timely intervention such as lower the threshold for diagnostic laparoscopy and selective mesenteric angiography may improve the outcome of this group of patients.

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Accuracy of diagnostic laparoscopy for early diagnosis of abdominal complications after cardiac surgery

Cited by 45 publications

References 19 publications

Ischemic colitis—analysis of risk factors for postoperative mortality

Ischemic colitis—analysis of risk factors for postoperative mortality

Diagnosis and treatment of postoperative intestinal perforation in infants and young children with congenital heart disease: A report of three cases

A case report of acute mesenteric ischemia post coronary artery bypass graft with concomitant aortic valve replacement

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