Colon Ischemia following Infrarenal Aortic Surgery

Miller, Rc.; Knox, W G

doi:10.1097/00000658-196604000-00019

Cited by 15 publications

(4 citation statements)

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“…In adults, ischaemic disease of the bowel has been the subject of a number of studies, and major vessel occlusion has been shown to be important in clinical (Marston et al, 1966;Miller and Knox, 1966) and experimental (Marston et a]., 1969) situations. The role of small-vessel obstruction was also emphasised by Boley et af.…”

Section: Discussionmentioning

confidence: 99%

The production of mucosal ulceration in the rabbit gut by intra‐arterial injection of microspheres

Aaronson

Berry

1970

The Journal of Pathology

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Section: Discussionmentioning

confidence: 99%

The production of mucosal ulceration in the rabbit gut by intra‐arterial injection of microspheres

Aaronson

Berry

1970

The Journal of Pathology

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“…Bei 85% stellt sich diese Komplikation nach Resektion von Bauchaortenaneurysmen und bei 15 O//o nach Bypassoperation bzw. Die Letalitat der schwersten Form, namlich des transmuralen Dickdarminfarktes bewegt sich zwischen 40 und 100%; die Mittelwerte liegen bei 60-75~o [1,4,5,15,17,27,32,34,37,44,52,59,68]. Die Incidenz liegt bei elektiv operierten Aneurysmen etwa dreimal h6her als in der AVK-Gruppe [17,32].…”

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Isch�mische Colitis nach rekonstruktiven Eingriffen im aorto-iliacalen Gef��abschnitt

Vollmar

Fleischmann

1985

Langenbecks Arch Chiv

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Ischemic colitis after aortoiliac vascular reconstructions represents a seldom but life-threatening postoperative complication (incidence: 1.6%, mortality rate: 50-70%). The authors present a retrospective evaluation of 10 cases observed in a consecutive series of 1121 reconstructive aorto-iliac procedures. The incidence of ischemic bowel complications was 1.3% in the group of abdominal aortic aneurysms but only 0.6% in the group of arterial occlusive disease. The pathogenesis including new approaches of prophylaxis, diagnostic and therapeutical measures are discussed. The risk of ischemic damage to the bowel may be best assessed from the preoperative aortogram (special vascular patterns), the intraoperative stump-pressure measurement in the inferior-mesenteric artery and the pre- and postoperative PB-Index. In contrast to earlier reports the leading clinical symptom is an unexplained prolonged gastrointestinal paralysis during the first postoperative week. Early diagnosis is most important and best realized by the routine use of colonscopy in all risk cases in the first 48 h. Such an aggressive diagnostic approach offers the possibility of early relaparotomy in a pretoxic stage and a better outcome for the patient than heretofore with a median delay of 11 days between vascular reconstruction and relaparotomy.

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“…Recent clinical experience (Boley, Schwartz, Lash, and Sternhill, 1963;McGovern and Goulston, 1965;Marston, Pheils, Thomas, and Morson, 1966;Miller and Knox, 1966;Sturdy, 1968) has suggested that many cases of hitherto obscure colonic disease may in fact originate from vascular insufficiency. Some of these cases are directly attributable to blockage of a major vessel by thrombosis or embolism (Marston et al, 1966;Miller and Knox, 1966) whilst in others the ischaemia originates from occlusion or spasm of the smaller intramural vessels (Boley, Krieger, Schultz, Robinson, Siew, Allen, and Schwartz, 1965).…”

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confidence: 99%

“…Some of these cases are directly attributable to blockage of a major vessel by thrombosis or embolism (Marston et al, 1966;Miller and Knox, 1966) whilst in others the ischaemia originates from occlusion or spasm of the smaller intramural vessels (Boley, Krieger, Schultz, Robinson, Siew, Allen, and Schwartz, 1965). The diagnosis of colonic infarction is not always easy and the clinical features, x-ray appearances, and pathology are still not completely defined.…”

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confidence: 99%