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[Intestinal infarction after ruptured aneurysm of the abdominal aorta. Clinical contribution]
F Giordanengo1, M Boneschi, P G Vandone
1Universita degli Studi - Milano, Istituto di Chirurgia Generale e Cardiovascolare.
Abstract:
Acute mesenteric ischemia is a severe complication after aortic reconstructive surgery for AAA repair. This ischemic event, due to a poor intestinal perfusion especially in ruptured AAA in consequence of the hypotension and the hypovolemic shock, shows different clinical manifestations such as delayed canalization, ischemic colitis or more serious like intestinal infarction. Between 1989 and 1994, 965 cases of abdominal aortic aneurysms have been surgically treated in General and Cardiovascular Surgery Institute of University of Milan. Rupture had occurred in 150 patients, and intestinal infarction was observed in 6 cases (3.9%). Mortality rate of 33% was observed. Etiology and technical procedures to avoid this complication are discussed.
Insights
Acute mesenteric ischemia, a severe complication following abdominal aortic aneurysm (AAA) repair, can lead to intestinal infarction. This study analyzes its occurrence and mortality in AAA surgery patients.
Area of Science:
- Cardiovascular Surgery
- Gastroenterology
- Vascular Surgery
Context:
- Acute mesenteric ischemia is a severe complication after aortic reconstructive surgery for abdominal aortic aneurysms (AAA).
- Ruptured AAA cases present higher risks due to hypotension and hypovolemic shock, leading to poor intestinal perfusion.
- Clinical manifestations range from ischemic colitis to intestinal infarction.
Purpose:
- To analyze the incidence of intestinal infarction after AAA repair.
- To discuss the etiology and preventive technical procedures for this complication.
Summary:
- Between 1989 and 1994, 965 AAA surgical repairs were performed.
- Intestinal infarction occurred in 6 out of 150 ruptured AAA cases (3.9%).
- A significant mortality rate of 33% was observed in these cases.
Impact:
- Highlights the critical risk of intestinal infarction in AAA surgery, particularly with ruptured aneurysms.
- Emphasizes the need for improved surgical techniques to minimize mesenteric ischemia complications.
- Informs strategies for reducing mortality associated with post-AAA repair mesenteric ischemia.