Slide 18 -
Open Repair Complications:Colon Ischemia Collaterals from SMA, IMA, internal iliac artery, and profunda femoris supply sigmoid colon
Mortality 40-65%, full-thickness necrosis 80-100%
Occurs in 0.6-3% of elective and 7-27% of ruptured AAA (much more common endoscopically than clinically)
Si/Sx: persistent acidosis & shock, increased WBCs and lactate levels, fluid sequestration, bloody bowel movements.
Ischemia limited to mucosa/submucosa- npo, IVF, IV abx
Transmural ischemia- bowel resection, fecal diversion, creation of ostomy, washout of abdomen, IV abx.