A 73-year-old woman was diagnosed with coronary artery aneurysms associated with coronary-pulmonary arterial fistula in a preoperative examination for transverse colon cancer. One of the aneurysms (28 mm) originated from a branch of the right coronary artery and the other two (16 and 12 mm) originated from a branch of the left coronary artery. We performed surgery to prevent their rupture because the right coronary artery aneurysm showed a tendency to enlarge. Surgery was performed through a median sternotomy under cardiopulmonary bypass. Suture closure of the inflow and outflow of the aneurysm was performed. The coronary-pulmonary arterial fistula was ligated. In addition, suture closure of the outflow of the coronary-pulmonary artery fistula into the pulmonary artery was performed, under direct view after incision of the pulmonary trunk. No residual shunt blood flow in the coronary-pulmonary arterial fistula was observed on postoperative echocardiography. Furthermore, no coronary aneurysm and coronary-pulmonary arterial fistula was recognized on postoperative coronary computed tomography. The patient made an uneventful recovery and was discharged from the hospital on postoperative day 12.

BACKGROUND/AIMS: To determine the nutritional markers important for assessing the degree of pancreatic insufficiency due to chronic pancreatitis in routine clinical practice. METHODS: A total of 137 patients with chronic pancreatitis were followed up for more than 1 year. They were divided into two groups: a pancreatic diabetes mellitus (DM) group, consisting of 47 patients undergoing medical treatment for DM of pancreatic origin, and a nonpancreatic DM group, consisting of 90 other patients (including 86 patients without DM). Serum albumin, prealbumin, total cholesterol, cholinesterase, magnesium, and hemoglobin were compared between the two groups. RESULTS: The total cholesterol was significantly lower in the pancreatic than the nonpancreatic DM group (164 mg/dL vs 183 mg/dL, respectively; p=0.0028). Cholinesterase was significantly lower in the former group (263 U/L vs 291 U/L, respectively; p=0.016). Among the 37 patients with nonalcoholic pancreatitis, there was no difference in the cholinesterase levels between the pancreatic and nonpancreatic (296 U/L vs 304 U/L, respectively; p=0.752) DM groups, although cholesterol levels remained lower in the former (165 mg/dL vs 187 mg/dL, respectively; p=0.052). CONCLUSIONS: Cholinesterase levels are possibly affected by concomitant alcoholic liver injury. The total cholesterol level should be considered when assessing pancreatic insufficiency due to chronic pancreatitis.
Adult ; Aged ; Aged, 80 and over ; Cholesterol/*blood ; Cholinesterases/blood ; Diabetes Mellitus, Type 2/complications ; Exocrine Pancreatic Insufficiency/*blood/etiology ; Female ; Follow-Up Studies ; Humans ; Liver Cirrhosis, Alcoholic/blood ; Male ; Middle Aged ; Nutritional Status ; Pancreas/enzymology ; Pancreatitis, Alcoholic/blood/complications ; Pancreatitis, Chronic/blood/*complications ; Serum Albumin/analysis