Related Experiment Video
Updated: Jul 26, 2026
05:58
Surgical Trunk Oriented Laparoscopic Right Hemicolectomy (ST-LRH) for Right-Sided Colon Cancer
Published on: July 25, 2025
Sigmoid colon exteriorization after ruptured abdominal aortic aneurysm
S Funahashi1, A Osoegawa, T Matsumata
1Department of Surgery, Section of Vascular Surgery, Saiseikai Yahata General Hospital, Kitakyushu, Fukuoka, Japan.
The Journal of Cardiovascular Surgery
|June 19, 2003
Summary
Ruptured abdominal aortic aneurysm (AAA) repair complicated by sigmoid colon ischemia. Exteriorizing the colon allowed delayed resection, preventing graft infection and aiding patient survival.
Area of Science:
- Vascular Surgery
- Gastrointestinal Surgery
- Surgical Critical Care
Background:
- Ruptured abdominal aortic aneurysms (AAA) are life-threatening emergencies requiring prompt surgical intervention.
- Colonic ischemia is a serious complication following AAA repair, particularly in ruptured cases.
- Simultaneous repair of AAA and colon resection increases risks, necessitating careful surgical planning.
Observation:
- A 74-year-old male presented with a ruptured AAA and underwent emergency aneurysmectomy with graft replacement.
- Intraoperative findings revealed sigmoid colon discoloration and spasm, suggestive of ischemia.
- The sigmoid colon was exteriorized to monitor for ischemia, avoiding immediate resection.
Findings:
- Postoperatively, the exteriorized colon showed worsening patchy ischemia, necessitating a sigmoid colectomy and end colostomy on the 4th day.
- The patient developed multisystem organ failure but eventually recovered.
- Exteriorization facilitated timely diagnosis of colonic ischemia and allowed a delayed, lower-risk second-look operation.
Implications:
- Colon exteriorization is a valuable strategy in managing suspected colonic ischemia during ruptured AAA repair.
- This approach minimizes infection risk to the prosthetic graft and allows for staged management of bowel compromise.
- Careful intraoperative assessment and staged surgical procedures are crucial for improving outcomes in complex AAA cases.
Related Concept Videos
01:21Inflammatory Bowel Disease V: Surgical Management
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
01:25Endoscopic Procedures II: Colonoscopy
The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
01:26Aneurysm III: Interprofessional Care
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
01:07Intestinal Obstruction II: Pathophysiology
Intestinal obstruction triggers a series of physiological responses, starting with gas and fluid accumulation in the bowel segment proximal to the obstruction, leading to distension. This distended intestine compresses the diaphragm, hindering lung expansion and potentially leading to reduced respiratory effort, atelectasis, and pneumonia.To overcome the blockage, the gut intensifies contractions, causing colicky abdominal pain, nausea, and vomiting, which reduces fluid and food intake and...
01:27Diverticular Disease of the Colon
Diverticular disease involves the formation of diverticula—small sac-like outpouchings of the colonic wall—and their complications. It most commonly affects the sigmoid colon due to higher intraluminal pressure and structural vulnerability. It results from structural weakness and increased pressure in the colon, producing pseudodiverticula that may remain silent or progress to inflammation and serious complications.Structure of DiverticulaIn diverticulosis, these outpouchings are...