A Case of Infrarenal Aneurysms Abdominal Aneurysm Associated with Bilateral Internal Iliac Artery Aneurysms / 日本心臓血管外科学会雑誌

ABSTRACT

Ischemic colitis is a serious complication of abdominal aortic surgery. Patients with bilateral internal iliac aneurysm have a high risk of ischemic colitis after operation. A 72-year-old man had infrarenal abdominal aneurysm, bilateral common and internal iliac aneurysm and an occluded right internal iliac artery. We examined the flow of the superior rectal artery during operation by transanal Doppler, and intramucosal pH of the sigmoid colon by a tonometer after operation. The flow of the superior rectal artery did not change after clamping of the left common iliac artery, clamp of the infrarenal aorta. He underwent uneventful abdominal aortic aneurysmectomy, Y-grafting and exclusion of bilateral internal iliac aneurysms. The intramucosal pH of the sigmoid colon returned to the normal range 25h after surgery. He had no complications after surgery. Transanal Doppler examination was essential for the successful prevention of postoperative colonic ischemia, and intestinal intramural pH by tonometry was an early reliable marker of the absence of ischemic colitis.