Although the incidence of gastrointestinal complications during cardiac surgery is low, delayed recognition of these complications may result in prolonged hospitalization with a high mortality rate. The diagnosis is usually difficult, as the patient may not describe symptoms due to sedation and analgesia early after surgery. A 56-yearold male patient who was diagnosed with acute coronary syndrome underwent an urgent off-pump coronary artery bypass graft (CABG) surgery. The patient with a normal early postoperative period had a severe abdominal pain followed by hemodynamic corruption. He underwent a diagnostic laparotomy with a preliminary diagnosis of acute mesenteric ischemia. Surgical examination revealed Crohn’s disease with bowel perforation. The diagnosis was confirmed by serologic tests (positive result for Anti- Saccharomyces Cerevisiae Antibody and negative result for anti-neutrophil cytoplasmic antibody) and pathologic examination. The bowel perforation is a rare complication of Crohn’s disease. This is the first reported case in the literature associated with coronary artery disease.

Keywords : Bowel perforation; Crohn’s disease; off-pump coronary artery bypass graft surgery