外科ジャーナル

Isolated Celiac Trunk Dissection after Cardiac Surgery

Abstract

Francesco Terrieri, Marzia Cottini, Marco Picichè, Stefano Rausei and Cesare Beghi

The most catastrophic postoperative gastrointestinal complication in cardiac surgery is mesenteric ischemia, which is frequently fatal. This may result from atheroembolization, heparin-induced thrombocytopenia or hypoperfusion. We reported the case of 72 year old man undergone to coronary artery bypass and aortic valve replacement, presented isolated celiac trunk dissection after surgery. CT scan described a dissection flap of the first part of celiac trunk possible due to ulcerative plaque without note of anterograde or retrograde development. Considering patient's hemodynamic, respiratory and general trend, we decided to choose conservative management. The sequent postoperative period was uneventfully, the patient was hemodynamically stable and he was discharged at the 20th postoperative day. The atheroembolization was a life-threatening problem of all vascular districts: a correct CPB pressure and postoperative BP monitoring could help to reduce the incidence of its complications.