Colonic ischemia developed after laparoscopic colectomy for rectosigmoid cancer with focal infrarenal aortic stenosis.

A 69-year-old woman with focal infrarenal aortic stenosis was diagnosed with rectosigmoid cancer. Because radical resection for colon cancer required dissection of vessels that supplied blood flow to the legs, revascularization by aortic stent placement was performed before the colectomy. We subsequently performed laparoscopic low anterior resection without any complications. Two and a half years after colectomy, however, the patient developed colonic ischemia due to thrombosis of the dilated marginal artery that served as a collateral artery before stenting. We performed laparoscopic partial colectomy, including the resection of the dilated marginal artery filled with thrombus. An abnormally dilated ex-collateral artery was thought to have caused vessel occlusion, presumably due to an imbalance in blood flow and vascular diameter.