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%
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