A 77-year-old man underwent an exploratory laparotomy and right hemicolectomy for bowel ischemia. An etiology that has been investigated was hypotension leading to hypoperfusion. Intraoperatively, the patient experienced hypotension with a decline in mean arterial pressure from 150 mmHg to 30 mmHg for a duration of 20 minutes. Postoperatively the patient had another episode of hypotension with a decline in mean arterial pressure from 80 mmHg to 55 mmHg for a-15-minute period. On post-operative day three the patient was paraplegic with spinal cord infarction seen on magnetic resonance imaging from T10 to the conus medullaris. The blood supply to this region appeared unobstructed on imaging and therefore it is likely that intermittent hypotension was associated with insufficient blood flow to this region.
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