Summary: We present two patients who had massive prostatic infarctions following coronary bypass surgery. Whereas small areas of prostatic infarction are commonly seen in urologic practice, massive infarction is rarely seen. Massive prostatic infarction has been observed under conditions similar to those occurring with bypass surgery, so no claim is made that the condition occurs uniquely in patients who have recently undergone bypass surgery. Since coronary bypass surgery is commonly perfonned and since the procedure is often done on men with prostatic hypetplasia, we can reasonably expect to see this condition more commonly that we have in the past. It is our hope that others will be alerted to this condition and look for it in patients with prostatism who undergo coronary bypass surgery, other types of cardiac surgery, and any condition where prostatism and hypotension are present and pressor agents are used in treatment.

We report a case in which a prior distal splenorenal shunt for bleeding esophageal varices was preserved during subsequent left nephrectomy for adenocarcinoma. At nephrectomy portal hypertension with numerous collateral varices to the splenic vein was not a major technical problem. Shunt integrity was documented by postoperative angiography.