Perforated Peptic Ulcer After Coronary Bypass Grafting, Two Case Reports

Abstract

Introduction:
We are documenting two cases of duodenal perforation after coronary bypass grafting. There is stress of any operation but coronary bypass graft ing which is done with bypass assist has its own stress with occasionally super added prolonged ventilation, heavy inotropic sup port, intra aortic balloon counterpulsation due to pcrioperatjve complications.

Discussion:
Speranza V et a13 have shown exclusively that multiple organ trauma, sepsis, liver failure, renal transplantatiOfl bums, CNS injury produce stress with increased gastric acid productions which produces permeability of mucosa to hydrogen ions and alteration in volume and distribution of gastric blood flow and impaired energy status of mucosal cells which lead to stress ulcer syndrome. Froster A et a14 have shown that Cimetidine decreases the incidence of major gastric and duodenal bleeding in patients presenting with severe life threatening situations.