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Rectal strictures following abdominal aortic aneurysm surgery
1Department of Surgery, Kent and Sussex Hospital, Tunbridge Wells, UK.
Annals of the Royal College of Surgeons of England
|December 5, 2000
Summary
Rectal stricture is a rare complication after aortic aneurysm repair. Ischaemic proctitis can lead to strictures, requiring interventions like myotomy or, in severe cases, colostomy.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Colorectal Surgery
Background:
- Rectal stricture formation is an uncommon complication following aortic aneurysm repair.
- Inferior mesenteric artery ligation can compromise rectal blood supply.
Observation:
- Acute ischaemic proctitis, characterized by ulceration and necrosis, can occur due to hypotension and poor collateral circulation.
- This clinical entity is infrequently described in medical literature.
Findings:
- One patient with ischaemic proctitis secondary to aortic aneurysm repair responded to dilatation and posterior mid-rectal myotomy.
- A second patient did not respond to conservative management and ultimately required an end colostomy for intractable symptoms.
Implications:
- Early recognition of ischaemic proctitis is crucial for managing rectal strictures post-aortic aneurysm repair.
- Treatment strategies for rectal strictures vary, ranging from minimally invasive procedures to surgical intervention such as colostomy.