Determinants of Gastrointestinal Complications in Aortic Surgery

Gastrointestinal complications after aortic surgery are unusual; conse quently, their natural history has not been adequately defined. The authors reviewed 505 cases of aortic reconstruction done over a fourteen-year period in order to assess the clinical significance of postoperative gastrointestinal compli cations on outcome and to determine if there were preoperative or operative predictive factors for the development of such complications. There were 37 cases of gastrointestinal complications (7.3%). No significant difference was found between the complication rates after aneurysm resection versus aortic bypass for occlusive disease. Overall, the complication rates were: small bowel obstruction, 2.2%; gastrointestinal hemorrhage, 1.6%; small bowel ischemia, 1.2%; and colon ischemia, abdominal abscess, local trauma, pancreatitis, aor toenteric fistula and jaundice, each < 1%. More than one half of the complica tions occurred during the same hospitalization. Forty-three percent (16/37) were treated surgically, and these had a mortality of 44% (7/16) as opposed to 10% (2/21) for those with complications not requiring operation. Overall mor tality as a direct result of gastroint