Ischemia of the colon may follow surgical reconstruction of the aorta, and its extend can be graded based on clinical and pathologic features.
The sigmoid colon is a common location for ischemic colitis following repair of an abdominal aortic aneurysm with ligation of the inferior mesenteric artery.
Parameters:
(1) anatomic extent of involvement
(2) clinical findings
Anatomic Extent of Ischemia |
Clinical Findings |
Type |
mucosa and submucosa |
diarrhea, which may be bloody, starting 24-48 hours after surgery |
I |
into the muscularis propria |
intermediate |
II |
transmural |
shock, sepsis, peritonitis |
III |
Type |
Reversibility |
Morbidity and Mortality |
I |
reversible |
very low mortality |
II |
potentially reversible |
may develop stricture |
III |
irreversible |
mortality from 50-90% |
Specialty: Gastroenterology, Surgery, general, Cardiology