This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (71)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Causes, Diagnosis, Management, and Prevention

Leslie W. Ottinger, MD; R. Clement Darling, MD; Martin J. Nathan, MD; Robert R. Linton, MD

AMA Arch Surg. 1972;105(6):841-846.

Abstract
Infarction of the left colon was noted in about 2% of patients undergoing reconstruction of the distal aorta with interruption of the inferior mesenteric artery, and was associated with a mortality of 65%. The injury involved only the mucosa and healed completely in a few patients. In others the deeper layers were impaired and delayed strictures developed. Full-thickness necrosis was followed by perforation in the third group. Diarrhea, sometimes bloody, was the most helpful finding which led to the diagnosis but was absent in one third of the patients.

Prevention of the complication involves avoiding hypotension, trauma to the colon, and interruption of collateral arterial supply. Treatment required resection of the injured bowel and staged restoration of colon continuity when infarction extended beneath the mucosa.

Author Affiliations
Boston

From the Department of Surgery, Harvard Medical School, and General Surgical Services, Massachusetts General Hospital, Boston.

Footnotes
Accepted for publication July 13, 1972.

Read before the 20th scientific meeting of the International Cardiovascular Society, Carmel, Calif, June 23, 1972.

Reprint requests to 275 Charles St, Boston, Mass 02114 (Dr. Ottinger).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The Incidence of Colonic Ischemia with Retroperitoneal Aortic Reconstruction: A Prospective Study Emphasizing Early Selective Endoscopic Intervention
Brasch et al.
VASC ENDOVASCULAR SURG 1998;32:569-575.
ABSTRACT  

Case 9-1995- A 60-year-old man with hypertrophic cardiomyopathy and ischemic colitis
Moncure and Rashid
NEJM 1995;332:804-810.
FULL TEXT  

Predictive Model for Colonic Ischemia Following Abdominal Aortic Aneurysm Repair
Gerhart et al.
VASC ENDOVASCULAR SURG 1994;28:161-166.
ABSTRACT  

Paraprosthetic Abscess and Gangrenous Left Colon: A Unique Late Complication of Abdominal Aortic: Resection--A Case Report
Dickson et al.
VASC ENDOVASCULAR SURG 1990;24:536-539.
ABSTRACT  

Determinants of Gastrointestinal Complications in Aortic Surgery
Sheng et al.
VASC ENDOVASCULAR SURG 1987;21:257-264.
ABSTRACT  

Noninvasive Vascular Test with the 133Xe Clearance Technique in Assessment of Hypogastric Arteries Insufficiency
Setacci et al.
VASC ENDOVASCULAR SURG 1986;20:283-287.
ABSTRACT  

The Penile Brachial Index in the Preoperative Evaluation of Arterial Hypogastric Insufficiency
Setacci
VASC ENDOVASCULAR SURG 1986;20:162-165.
ABSTRACT  

Necrosis of the Colon Following Elective Resection of Abdominal Aortic Aneurysms
Goldschmidt et al.
VASC ENDOVASCULAR SURG 1975;9:141-146.
 

Vascular Surgery
JAMA 1972;222:1644-1645.
ABSTRACT