Complications of abdominal aortic surgery. II. Intestinal ischemia.

Abstract

Intestinal ischemia is an uncommon but often serious complication of reconstructive surgery of the abdominal aorta. The degree of ischemia may be mild, producing days or weeks of diarrhea and abdominal distention, yet reversible, and ultimately ending in recovery of the patient. Ischemia may be more severe, producing chronic ulceration that, when healed, may result in the formation of a stricture. Severe ischemia may lead to gangrene of the bowel, perforation, and peritonitis. The occurrence of intestinal ischemia has been reported in almost every large series of patients who have undergone abdominal aortic surgery. We have recognized this complication in 8 of 800 patients after abdominal aortic surgery; 6 of the 8 patients died. A review of the literature yielded 34 other cases with 17 deaths. Table 1 summarizes the data concerning the 42 patients. Clinical Data The series of 42 reported patients is comprised of 4 women and 38