Colonic Infarction Following Endovascular AAA Repair:A Multifactorial Complication
| Autor: | Chad Cheuk-Wa Tse, M.P. Armon, P.W. Wenham, Brian R. Hopkinson, Robert J. Hinchliffe |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
Colon medicine.medical_treatment Infarction 030204 cardiovascular system & hematology Inferior mesenteric artery 030218 nuclear medicine & medical imaging Blood Vessel Prosthesis Implantation 03 medical and health sciences Aortic aneurysm 0302 clinical medicine Aneurysm medicine.artery Laparotomy medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Vascular Patency Aged Splenic flexure business.industry Colostomy medicine.disease Abdominal aortic aneurysm Mesenteric Arteries Surgery Radiography cardiovascular system Female Radiology business Cardiology and Cardiovascular Medicine Aortic Aneurysm Abdominal |
| Zdroj: | Journal of Endovascular Therapy. 9:554-558 |
| ISSN: | 1545-1550 1526-6028 |
| Popis: | Purpose: To report a case of colonic infarction following endovascular abdominal aortic aneurysm (AAA) repair in a patient with both internal iliac arteries (IIA) unobstructed by the endograft. Case Report: A 73-year-old man presented with blue toes as a result of emboli from a 6.4-cm AAA. As he was medically at high risk for open repair and his aneurysm morphology was suitable for a modular bifurcated endovascular graft, a Zenith endograft was used to exclude the aneurysm. Twenty hours after the successful procedure, in which both IIAs were preserved, the patient regurgitated coffee-ground vomit; an upper gastrointestinal endoscopy found a small Mallory-Weiss tear and antral gastritis. A proton-pump inhibitor was begun, but his symptoms progressed. Laparotomy revealed transmural ischemia and infarction of the upper rectum, sigmoid, descending colon, and the splenic flexure; a colonic resection with formation of Hartmann's pouch and colostomy was performed. He made a slow but uncomplicated recovery. Conclusions: Colonic necrosis can complicate endovascular AAA repair even when both IIAs are preserved. Advantageously, the clinical signs of severe colonic ischemia in endograft patients are not obscured by aftereffects of a laparotomy. |
| Databáze: | OpenAIRE |
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