CRITICAL LOWER-LIMB ISCHEMIA FOLLOWING EXCISION OF THE RECTUM

Critical lower limb ischaemia can occur following rectal surgery by a number of mechanisms. Patients with aorto-iliac stenosis or occlusion may be dependent on collateral circulation to the lower limbs from the visceral arteries supplying the descending colon, sigmoid colon and t he rectum. Division of these collaterals can precipitate critical isch aemia of the leg. This is an uncommon scenario but one that should be considered in arteriopaths undergoing rectal surgery. Two cases of thi s complication are reported and the mechanisms discussed. (C) 1998 The International Society for Cardiovascular Surgery. Published by Elsevi er Science Ltd. All rights reserved.