The acute surgical abdomen after cardiac surgery involving extracorporeal circulation

From 1972 through 1984, 7140 cardiac operations were performed at one university teaching hospital; they were reviewed to elucidate common factors in patients developing an acute surgical abdomen after cardiac surgery and extracorporeal circulation. Twenty-one patients (0.29%) developed an acute surgical abdomen in the period following cardiac surgery. The abdominal surgical complications were, in general, due to complications of peptic ulcer disease, decreased intestinal blood flow, and cholecystitis. There was no correlation between preoperative history, physical examination, cardiac function, laboratory data, and the subsequent development of an acute abdomen. Mortality rate, 24% after abdominal surgery, was increased with emergency cardiac operations, combined cardiac procedures, complications of cardiac surgery, unnecessary delay of abdominal surgery, and abdominal wound complications. Major abdominal wound complications were seen in 38%. Patients undergoing cardiac surgery may develop a variety of common abdominal surgical disorders. Patients so inclined cannot be identified prior to cardiac surgery. Ulcer prophylaxis, wound management, prompt resuscitation, and timely surgery are critical.