An Unusual Cause of Ileus in a Cardiovascular Surgery Patient

Abstract

Question: An 82-year-old man was admitted for urgent coronary artery bypass and concurrent mitral valve repair. Intraoperatively, he underwent cardiopulmonary bypass, epicardial pacing, and placement of 2 anterior mediastinal and 1 pleural chest tubes. After a relatively unremarkable initial postoperative course and non-narcotic pain control, concern for ileus developed on postoperative day 4. A nasogastric tube was placed out of concern for worsening somnolence, nausea, and the inability to safely tolerate oral intake.