Abdominal Problems in Children with Congenital Cardiovascular Abnormalities

Abstract

Background: Congenital cardiovascular abnormal- ity is an important cause of morbidity and mortality inchildhood. Both the type of congenital cardiovascularabnormality and cardiopulmonary bypass are respon- sible for gastrointestinal system problems. Aims: Intra-abdominal problems, such as paralytic ile- us, necrotizing enterocolitis, and intestinal perforation,are common in patients who have been operated orwho are being followed for congenital cardiovascularabnormalities. Besides the primary congenital cardio- vascular abnormalities, ischemia secondary to cardiaccatheterization or surgery contributes to the incidenceof these problems.Study Design: Cross-sectional study. Methods: In this study, we aimed to screen the intra- abdominal problems seen in patients with congenital cardiovascular abnormalities who had undergone surgical orangiographical intervention(s). Patients with congenitalcardiovascular abnormalities who had been treated medi- cally or surgically between 2000 and 2014 were analyzedretrospectively in terms of intra-abdominal problems. Thepatients demographic data, type of congenital cardiovas- cular abnormalities, the intervention applied (surgical, angiographic), the incidence of intra-abdominal problem(s),the interventions applied for the intra-abdominal problems, and the results were evaluated. Results: Fourteen (Group I) of the 76 patients withcongenital cardiovascular abnormalities diagnosis were operated due to intra-abdominal problems, and62 (Group II) were followed-up clinically for intra-abdominal problems. In Group I (10 boys and 4 girls), 11patients were aged between 0 and 12 months, and threepatients were older than 12 months. Group II included52 patients aged between 0 and 12 months and 10 patients older than 12 months. Cardiovascular surgicalinterventions had been applied to six patients in GroupI and 40 patients in Group II. The most frequent intra- abdominal problems were necrotizing enterocolitis andintestinal perforation in Group I, and paralytic ileus inGroup II. Seven of the Group I patients and 22 of theGroup II patients died. The patients who died in bothgroups had more than three congenital cardiovascularabnormalities in the same patient, and 80% of these patients had been operated for congenital cardiovascularabnormalities. Conclusion: The gastrointestinal system is involved inimportant complications experienced by patients withcongenital cardiovascular abnormalities. The mortalityrate was higher in operated patients due to gastrointestinal complications. Gastrointestinal complications aremore frequent in patients with cyanotic anomalies. Thepresence of more than one congenital cardiovascularabnormality in a patient increased the mortality rate.