September 1960

Necrosis of the Colon Following Resection for Abdominal Aortic Aneurysms

Author Affiliations

Rochester, Minn.
Section of Surgery, Mayo Clinic and Mayo Foundation. The Mayo Foundation, Rochester, Minn., is a part of the Graduate School of the University of Minnesota.

Arch Surg. 1960;81(3):373-378. doi:10.1001/archsurg.1960.01300030033005

Various complications contribute to the risk of resection for aneurysms of the abdominal aorta. Of these, significant ischemia of a portion of the colon has occurred often enough to warrant separate consideration. Four patients, comprising about 1% of Mayo Clinic experience, have died during the postoperative period as a direct result of this complication. This problem was anticipated at the advent of resectional therapy for abdominal aneurysms, but it became evident from practical experience that the inferior mesenteric artery could usually be divided close to the aorta with impunity; indeed, it was already occluded in many patients. Also, the adoption of the procedure of high ligation of the inferior mesenteric artery in resection for malignant lesions of the descending colon has provided a vote of confidence in the collateral arterial blood supply of this portion of the bowel.1 Excellent investigations such as that of Griffiths2 have added more

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