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Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado

2012, Number 2

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Rev Esp Med Quir 2012; 17 (2)

Necrohemorrhagic pancreatitis secondary to cardiopulmonary bypass in heart valvular surgery

Tarelo SJM, Jacobo VEJ, Omaña TJA, Díaz QG, Archundia GA, Martínez CME, Moreno AR

Language: Spanish
References: 11
Page: 131-136
PDF size: 365.99 Kb.


ABSTRACT

Mild hyperamylasemia and liver failure are some of the most frequent abdominal complications in cardiopulmonary bypass; however, when these evolve into the most severe degree of pancreatitis, mortality rises to over 50%, and it is really difficult to recover the patient, thus prognosis is severely darken. This paper reports the case of a 45-year-old female patient; who, from childhood, suffered of frequent throat infections and later dyspnea. Study protocol was positive for rheumatic mitral heart disease. Mitral valve replacement was performed, with prolonged ischemic and bypass times; intraoperative phase without further incident. In postsurgical ICU she evolved favorably with adequate hemodynamic parameters. Next day impairment of renal, pulmonary and hemodynamic functions began, so she required renal replacement therapy. Patient suffered hemoperitoneum, hypocalcaemia, severely elevated liver enzymes, hyperbilirubinemia, hyperamylasemia, and multiorgan failure. It was diagnosed necrohemorrhagic pancreatitis. Patient died in the postoperative intensive care unit.


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