Use of bedside laparoscopy to identify intestinal ischemia in postoperative cases of aortic reconstruction.

Gangrenous bowel after aortic reconstructive surgery is associated with an exceptionally high mortality rate. Numerous diagnostic modalities have not reduced the incidence of death from infarcted bowel because of their lack of specificity and the associated delays in diagnosis. Recently, we have begun to use bedside laparoscopy to identify suspected gangrenous bowel in critically ill postoperative patients. Herein we describe a case of small-bowel infarction after aortic aneurysm surgery that was identified by the use of a laparoscope, with successful surgical repair and return of bowel function. Postoperative gangrenous bowel, standard diagnostic tests used in this setting, and the use and indications for beside laparoscopy are reviewed.