Acute pancreatitis, usually caused by enzyme activation, can develop after major surgery and various forms of shock. The aim of this study was to evaluate the incidence and risk factors of acute pancreatitis after cardiac surgery. We performed a retrospective study which included patients who underwent cardiac surgery at IUBCVT Targu-Mures from 2004 to 2009. We evaluated the postoperative evolution of 4612 patients; in those who died we performed also the histopathological examination of the pancreas. Out of 97 autopsied cases, we found hemorrhagic necrotizing pancreatic lesions in 16. None of the patients showed clinical signs suggestive for acute pancreatitis. All of them had low cardiac output and received large doses of vasoconstrictors, which worsened the splanchnic hypoperfusion. Acute pancreatitis is a rare complication of cardiac surgery, but may increase the postoperative mortality, and a more aggressive approach of high-risk patients is necessary in order to detect and treat any pancreatic lesions.
Keywords: hemorrhagic necrotizing pancreatitis, cardiac surgery, splanchnic hypoperfusion, histopathological examinations