Ischemic Colitis Following Abdominal Aortic Aneurysm Surgery

Abstract

Ischemic colitis (IC) following abdominal aortic aneurysm surgery has been well-reported in the literature as a highly lethal complication. The overall incidence of IC is between 1 and 7%, the incidence being highest following repair of ruptured abdominal aortic aneurysms. Mortality rates with this complication have been shown to be as high as 54%. With such a high incidence and mortality rate, prevention, early detection and treatment are of significant importance in the management of this complication. This paper discusses primary and secondary prevention of IC following abdominal aortic aneurysm surgery. Primary prevention is targeted at the preoperative and intraoperative levels. Preoperative prevention involves looking at the preoperative risk factors, both anatomic and hemodynamic subgroups. Several techniques of intraoperative detection of 1C reported in the literature are also discussed. Secondary prevention involves early detection of IC and management in the postoperative period to allow for institution of supportive measures. Important early warning signs of postoperative IC, as well as the reported use of flexible sigmoidoscopy to reliably predict and diagnose the complication, are addressed.