[Acute ischemic myelomalacia and colon necrosis in infrarenal aortic aneurysm]

A 54-year-old man suddenly developed a transverse spinal cord syndrome with paralysis of both legs and diffuse abdominal pain. Spinal compression was excluded by myelography. Subsequent computed tomography, however, revealed an aortic aneurysm of 7 cm diameter. At laparotomy extensive mesenteric ischaemia with necrosis of the entire colon and massive peritonitis were noted. It was not possible, because of the peritonitis, to bypass the aneurysm with a graft and only a colectomy was performed. The patient died 48 hours after admission of prolonged cardiocirculatory failure. Autopsy revealed further multiple organ damage in addition to the ischaemic myelomalacia. The common cause of the findings was probably a sudden drop in blood pressure in the presence of severe generalized arteriosclerosis.