Risk factors for ischemic colitis following surgery on the abdominal aorta:
(1) improper ligation of the inferior mesenteric artery, with interruption of communication between the ascending left colic artery and the descending sigmoid branches
(2) failure to restore blood flow in the inferior mesenteric or hypogastric arteries
(3) ruptured aortic aneurysm with a hematoma compressing the mesentery
(4) hypotension and hypoperfusion
(5) manipulative trauma to the bowel (use of retractors, excessive packing, etc), with occlusion of the mesenteric collateral channels
(6) inadequate collateral circulation (congenital blood supply, atherosclerotic disease, other)
(7) damage to the meandering mesenteric artery or other collateral blood vessels
(8) dislodgment of embolic debris from aorta
where:
• The meandering mesenteric artery supplies collateral blood flow from the superior to inferior mesenteric arteries. It runs between the left branch of the middle colic and the left colic arteries. Other names include the marginal artery, central anastomotic artery, and artery of Drummond.
