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Case Report
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| A case report of acute mesenteric ischemia post coronary artery bypass graft with concomitant aortic valve replacement | ||||||
| Karthigesu Aimanan1, Yee Ling Tan2, Saravana Kumar Karupiah3, Muhammad Nor3, Mohamad Arif3, Chew Loon Guan2, Balaji Padmanaban3 | ||||||
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1Department of General Surgery, National University of Malaysia, Malaysia.
2Department of Vascular and General Surgery, Serdang Hospital, Selangor, Malaysia. 3Department of Cardiothoracic Surgery, Serdang Hospital, Selangor, Malaysia. | ||||||
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| How to cite this article |
| Aimanan K, Tan YL, Karupiah SK, Nor M, Arif M, Guan CLPadmanaban B. A case report of acute mesenteric ischemia post coronary artery bypass graft with concomitant aortic valve replacement. Int J Case Rep Images 2016;7(6):392–396. |
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Abstract
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Introduction:
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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Keywords:
Acute mesenteric ischemia, Mesenteric angiography, Diagnostic laparoscopy
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Author Contributions
Karthigesu Aimanan – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Yee Ling Tan – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Saravana Kumar Karupiah – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Muhammad Nor – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Mohamad Arif – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Chew Loon Guan – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Balaji Padmanaban – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2016 Karthigesu Aimanan et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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