Rectal necrosis following anterior resection of the rectum

Acute ischaemic colitis is a well recognized complication following abdominal surgery. It may occur spontaneously in older patients and is probably due to diffuse or localized obliterative arterial disease. In contrast, acute ischaemic proctitis is a rare clinical problem. It is caused by an acute surgical or thromboembolic interruption of the major blood supply and or collateral circulation of the rectum. Minor ischaemia may result in superficial mucosal ulceration whereas a major ischaemic episode will result in rectal necrosis with perforation. Acute rectal necrosis has not been reported as a complication following anterior resection of the rectum. This paper details a patient who developed necrosis of the rectum and the anal canal following anterior resection of the rectum for cancer of the recto-sigmoid junction.