Abdominal problems in children with congenital cardiovascular abnormalities

Introduction: Intraabdominal problems as paralytic ileus, necrotizing enterocolitis (NEC) and intestinal perforation are not rare in patients who have been operated or being followed for congenital cardiovascular anomalies (CCVA). Besides the primary CCVA, ischemia secondary to cardiac catheterization or surgery contribute the occurrence of those problems. Patients and Method: In this study, it is aimed to screen the intraabdominal problems seen in patients with CCVA, who had undergone surgical or angiographical intervention(s). Patients with CCVA who have been treated medically or surgically between 2000 – 2007 have been analysed retrospectively in terms of intraabdominal problems. The patients' demographic data, type of CCVA, the intervention applied (surgical, angiographical), the incident of intraabdominal problem(s), the interventions applied for the intraabdominal problems and the results were evaluated. Findings: Eleven (23,9%, Group I) of the 46 patients with CCVA diagnosis were operated due to intraabdominal problems and 35 were (76,1%, GroupII) followed up clinically. Surgical interventions were applied to 5 patients in Group I and 24 patients in Group II. The most frequently seen intraabdominal problems were NEC and intestinal perforation in Group I and abdominal distention in Group II. Five of the Group I patients and 10 of the Group II patients died. The patients who died in both groups had more than 3 CCVA in the same patient. 80% of those patients had been operated for CCVA. Discussion: Gastrointestinal system is involved in important complications experienced by patients with CCVA. Mortality rate is higher in patients operated due to gastrointestinal complications. Gastrointestinal complications are more frequent in patients with cyanotic anomalies. Presence of more than one CCVA in a patient increases mortality rate.