Subacute ischaemic proctitis: A rare condition requiring extensive rectal surgery

Subacute ischaemic proctitis is a rare condition. We describe the case of a 60-year-old male patient who developed, after aortic aneurysm repair, a tr ansient ischaemic colitis that totally healed without sequelae. He eventual ly developed symptoms of severe proctitis. Investigations identified a sten osis of the mid rectum, while the upper rectum was inflammatory. On angiogr am, there was a poor blood flow through the Riolan's arcade and a stenosis of the proximal aorto-graft anastomosis. Diagnosis of subacute ischaemic pr octitis due to poor blood supply through the internal iliac arteries was ma de. Anti-inflammatory drugs and dilations were inefficient. A subtotal proc tectomy with low colorectal anastomosis was required. On pathological speci men, the lesions were strongly suggestive of an ischaemic process. The pati ent had an excellent recovery and was asymptomatic 8 months after the opera tion.