Background & Aims : Left-sided pleural effusion (PE) is one of the features of acute aortic dissection (AD). The present study was undertaken to clarify the relation between the presence of PE and the time interval from the onset of dissection, and the laterality of PE. Methods : We retrospectively studied patients with a confirmed diagnosis of acute AD who had undergone multidetector-row CT (MDCT). The presence of PE and its laterality in patients with acute AD were evaluated by MDCT. The relationship between the presence of PE and the time interval from onset to CT scan was evaluated. Results : Twelve patients underwent MDCT within 7 hours of the onset of acute AD. PE was observed only in three patients (25%) who had undergone MDCT more than 4 hours after the onset. The average time from symptom onset to CT scan was longer in patients with PE than in those without PE (343±86 vs. 120±80 minutes ; P=0.002). The laterality of PE varied among three patients. Conclusions : The current study reveals the incidence of PE to be 25% within 7 hours of the onset of acute AD and suggests the presence of PE to be dependent on the time interval since onset. Furthermore, we observed no patterns regarding the laterality of PE.
Purpose : The purpose of this study was to examine the incidence, clinical features, treatment and outcome of patients with gastrointestinal complications after cardiovascular surgery in our hospital. Patients and Methods : Between January 1992 to February 2004, 835 patients were operated with cardiopulmonary bypass (CPB) at Gunma University Hospital. Of these, 12 (1.4%) patients had postoperative gastrointestinal complications. The mean age of 12 patients was 59 years old ranging from 7 to 71. Valve replacements were performed in six patients, CABG in three, and others in three. Results : Gastrointestinal bleeding occurred in seven patients. Six of them recovered with non-surgical procedure, and one died of hemorrhagic shock following an emergency operation. Acute cholecystitis occurred in three patients and all of them were successfully managed by percutenous transhepatic gall bladder drainage (PTGBD). Two patients with gastrointestinal perforation underwent an emergent operation, however, both of them died of sepsis. The total mortality rate of 12 patients was 25%. Conclusion : The occurrence of gastrointestinal complications after cardiovascular surgery with cardiopulmonary bypass is low, however, is frequently fatal. Preoperative careful evaluation of patients is required for the postoperative management of those complications.