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Canadian Journal of Surgery. Journal Canadien De Chirurgie
|November 1, 1981
Summary
Intestinal ischemia after aortic surgery is a serious complication. Early diagnosis is crucial, as transmural bowel infarction leads to a poor prognosis, with a 70% overall mortality rate in identified cases.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Abdominal Surgery
Background:
- Intestinal ischemia is a critical complication following aortic surgery.
- Clinical indicators include severe abdominal pain, diarrhea, and metabolic acidosis.
- A 10-year review identified 10 cases at Toronto General and Toronto Western hospitals.
Purpose of the Study:
- To identify and analyze cases of intestinal ischemia post-aortic surgery.
- To determine the mortality and morbidity associated with this complication.
- To highlight potentially preventable factors and emphasize early diagnosis.
Main Methods:
- Retrospective review of 10 patient cases over a 10-year period.
- Analysis of surgical procedures preceding ischemia (ruptured aneurysm repair, elective aneurysmectomy, bypass for occlusive disease).
- Assessment of outcomes including mortality, bowel infarction extent, and late strictures.
Main Results:
- Overall mortality was 70% (7 out of 10 patients).
- Six patients with transmural bowel infarction all died.
- Four patients with partial-thickness injury had one death and three late strictures.
Conclusions:
- Intestinal ischemia following aortic surgery carries a high mortality rate.
- Early diagnosis is paramount, as transmural necrosis significantly worsens prognosis.
- Identification of preventable factors is essential for improving patient outcomes.