Necrosis of the colon and the rectum after resection of ruptured abdominal aortic aneurysm.

Two male patients with gangrene of the rectum and left colon following operation for a ruptured abdominal aortic aneurysm are reported. Both patients were in shock over a prolonged period, but ligation of the inferior mesenteric artery in the presence of insufficient collateral circulation to the large bowel was regarded as the main responsible factor for the visceral infarction. Both patients died postoperatively. The anatomical and pathophysiological factors generally involved in the development of colon ischaemia after abdominal aortic aneurysm surgery are analyzed. The different modalities of prevention of colon necrosis, diagnosis and management of the established lesions are described.