HISTOLOGICAL STUDY OF COLONIC ISCHEMIA AFTER AORTIC-SURGERY

Background Colonic ischaemia is a well documented complication of abdo minal aortic reconstruction. In this prospective study patients had ro utine preoperative and postoperative colonoscopy and biopsy, in order to determine the true incidence and implications. Methods Fifty-six pa tients undergoing elective infrarenal aortic surgery, 28 for aneurysm and 28 for occlusive disease, had colonoscopy and biopsy before and 1 week after operation. Results Colonic ischaemia was identified histolo gically in biopsies from 16 (30 per cent) of 53 patients. Almost half the patients had normal macroscopic appearances. Two factors exhibited a statistically significant association with the development of ischa emia: prolonged cross-clamp time (P < 0.05) and postoperative diarrhoe a (P < 0.001). Co-morbidity was much higher in patients with colonic i schaemia (P < 0.005). Overall morbidity was significantly greater in t he aneurysm group (P < 0.05). Conclusion Colonic ischaemia is common a fter aortic reconstruction. When suspected, colonoscopy with biopsy is diagnostic.