Page 21 - Virtual Vascular Volume 7
P. 21
Colon Necrosis
A 70-year old man presented with a ruptured
9cm AAA. CT scan on the left showed a large
retroperitoneal hematoma on the right side.
He underwent a successful emergency EVAR
with a on table fenestrated graft. Days later he
developed necrosis of his right colon. Emergen-
cy laparotomy and colon resection was done.
COLON NECROSIS after open or endovascular
AAA repair is rare. The IMA is often sacrificed
in these repairs and may be contributory. Colon
complications are also more common after rup-
tured AAA repair due to disruption of the colon-
ic collaterals by the hematoma, and also shock.
Usually the sigmoid colon is affected. In this
case with the ascending colon ischemia one
should also think of intra-operative embolization
from the SMA stent.
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