Thrombosis of peripheral aneurysms. A complication of colorectal surgery

Colorectal surgery performed with patients in the lithotomy position resulted in acute limb ischemia due to thrombosis of unrecognized peripheral aneurysms. A search of the literature failed to find this complication reported. It is postulated that the mechanism of injury is due to calf compression in the lithotomy position and/or external iliac artery compression by a retractor. Awareness of the peripheral aneurysm prior to colorectal surgery and appropriate modification of the operative approach should prevent this complication.