Gangrenous ischaemic colitis following lung wedge resection

A 77-year-old man, who was taking prednisolone 7.5 mg, underwent wedge resection for nodules in the right lower lobe of the lung. The nodules were diagnosed as amyloid tumour. On the sixth postoperative day, sudden tachycardia, fever, creatine phosphokinase increase, renal dysfunction and metabolic acidosis were observed. CT showed no signs of infection, exacerbation of interstitial pneumonia, pulmonary embolism or occlusion in the major vessels of the mesentery. Exploratory laparotomy revealed intestinal necrosis in the inferior mesenteric artery area, and left hemicolectomy was performed. Postoperative pathological examination revealed gangrenous ischaemic colitis. Although gangrenous ischaemic colitis is not a complication specific to general thoracic surgery, it can be fatal. Because of the high risk of developing gangrenous ischaemic colitis in elderly patients and the increase in concomitant diseases, thoracic surgeons should always be mindful of the condition.