Patterns of Severe Pancreatic Injury Following Cardiopulmonary Bypass

Abstract

Severe pancreatic complications following cardiac surgery are rare, but 14 patients with severe pancreatitis were encountered since 1971. Six of these developed acute fulminating pancreatitis following cardiac surgery and each of these died within 21 days following operation. Patients (7) had less severe pancreatitis, resulting in pancreatic abscess formation and 5 in this group expired. One patient developed a pancreatic pseudocyst following mild acute pancreatitis and expired 4 mo. 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 [computed tomography] scan. Despite aggressive surgical therapy, pancreatitis following cardiopulmonary bypass is an extremely serious condition.