Koroner Arter By-Pass Cerrahisi Sonrası Gelişen Şiddetli Hiperbilirubinemi Vakası

Öz

Kardiyak cerrahi sonrası postoperatif hiperbilirubineminin sıklığı ve paterni ile komlikasyonları iyi tanımlanmamıştır. Karaciğer disfonksiyonuna bağlı postoperatif hiperbilirubinemi, artan morbidite ve mortalite ile ilişkili olabilir. Biz burada koroner arter bypass cerrahisi sonrası yapılan ekokardiyografide sağ ventrikül kollapsı ve perikardiyal hematom saptanan ve hematom boşaltılması sonucu hemodinamik tablosu düzelen hastayı sunduk. Hastanın total ve direkt bilirubin seviyeleri reoperasyonun birinci gününde, sırasıyla 8,3 mg/dl ve 2,3 mg/dl ye yükseldi. Takipte altıncı günde bilirubin seviyesi maksimum 23.1 mg/dl’ye çıktı. Ultrasonografide hepatik doku ve bilirubin kanalları normal olarak değerlendirildi. Alanin aminotransferaz (ALT), aspartat aminotransferaz (AST) ve gama glutamil transferaz (GGT) gibi hepatik fonksiyon testleri normal olan hastaya spesifik bir tedavi verilmeden hiperbilirubinemi normal değerlere geriledi.

 

Anahtar Kelimeler

• Koroner arter bypass,hiperbilirubinemi,karaciğer fonksiyon testleri.

Severe hyperbiluribunemia after coronary artery by-pass surgery: a case report

Öz

The pattern and frequency of hyperbilirubinemia after cardiac surgery and its effect on postoperative complications are not well described. Postoperative hyperbilirubinemia due to liver dysfunction may be associated with increased morbidity and mortality. We present a 60-year-old male patient that we detected pericardial hematoma and collapsed right ventricle after the coronary artery bypass surgery. Patient’s clinical status was improved after the operation for evacuating hematoma. Total bilirubin and direct bilirubin levels of patient were increased up to 8,3 mg/dl  and 2,3 mg/dl respectively in the  first day of  re-operation. In follow up, bilirubin level reached to a maximum level of 23.1 mg/dl on sixth day. In ultrasonography hepatic tissue and bilirubin tract were normal. Hepatic function tests except bilirubin such as alanin aminotransferaz (ALT), aspartat aminotransferaz (AST) and gama glutamil transferaz (GGT) were in normal level. Hyperbilirubinemia resolved spontaneously without any specific treatment.

Anahtar Kelimeler

• Coronary artery bypass,hyperbilirubinemia,Liver function tests.

Kaynakça

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