Bowel ischemia following coronary artery bypass grafting: A rare and catastrophic postoperative complication

Gastrointestinal ischemia following coronary artery bypass grafting (CABG) is an uncommon occurrence; however, it can be fatal and is often triggered by hypoperfusion associated with cardiopulmonary bypass. We present a case involving a 56-year-old male with recurrent coronary artery disease who underwent CABG due to severe multivessel stenosis and in-stent restenosis. Postoperatively, he experienced progressive abdominal distension, and imaging studies indicated ischemia with caecal perforation. An emergency laparotomy revealed a markedly distended ileocecal junction with necrotic patches of the cecum, necessitating ileocecal resection and formation of an end ileostomy. The patient recovered satisfactorily and was discharged in stable condition. This case highlights the critical importance of early detection of postoperative bowel ischemia in patients undergoing cardiac surgery, as prompt surgical intervention is vital to avoid potentially fatal outcomes.