Report of a case of ischemic colitis with bilaterally patent internal iliac arteries after endovascular abdominal aneurysm repair.
10.4174/jkss.2012.82.3.200
- Author:
Hyangkyoung KIM
1
;
Tae Won KWON
;
Yong Pil CHO
;
Ki Myung MOON
Author Information
1. Department of Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea. hkkim@cau.ac.kr
- Publication Type:Case Report
- Keywords:
Abdominal aortic aneurysm;
Ischemic colitis;
Iliac artery;
Inferior mesenteric artery
- MeSH:
Abdominal Pain;
Aged;
Aneurysm;
Aortic Aneurysm, Abdominal;
Colitis, Ischemic;
Colon;
Colon, Sigmoid;
Early Diagnosis;
Embolism;
Humans;
Iliac Artery;
Infarction;
Ischemia;
Laparotomy;
Mesenteric Artery, Inferior;
Sigmoidoscopy;
Stents;
Transplants
- From:Journal of the Korean Surgical Society
2012;82(3):200-203
- CountryRepublic of Korea
- Language:English
-
Abstract:
During endovascular aneurysm repair (EVAR), interruption of the internal iliac arteries (IIAs) or the inferior mesenteric artery by stents or embolization is thought to cause colon ischemia. To minimize this risk, attempts have been made to preserve the IIAs using iliac branch devices or IIA revascularization. Here we present our experience of colon ischemia after EVAR in a patient with bilaterally patent IIAs without evidence of embolism. A 70-year-old man had abdominal pain and a ruptured abdominal aortic aneurysm was found. We performed EVAR with custom-made tube grafts preserving the bilateral IIAs. On postoperative day 2, the patient complained of abdominal pain, a sigmoidoscopy was performed revealing colon ischemia. On laparotomy, transmural infarction of the sigmoid colon was found and resected. Because IIA preservation cannot guarantee protection against colon ischemia, surgeons should maintain a high level of suspicion and use surveillance liberally after EVAR for early diagnosis of colon ischemia, even if both IIAs are preserved.
