Transmural ischaemic colitis following operation for ruptured abdominal aortic aneurysm

A total of 20 patients with transmural ischaemic colitis following operation for ruptured abdominal aortic aneurysm were studied (4 retrospectively and 16 prospectively). The diagnosis was made during laparotomy in five patients and by flexible sigmoidoscopy in 15 patients. Eighteen patients underwent large bowel resection (11 left-sided hemicolectomy, 7 subtotal colectomy). None of the 20 patients survived long enough to leave the hospital. The unfavourable prognosis of transmural ischaemic colitis following emergency abdominal aortic aneurysmectomy makes an early diagnosis by routine postoperative endoscopy mandatory and questions bowel resection in these patients.