Colonic ischemia after aortic reconstruction.

Colonic ischemia after aortic reconstruction is rare, but when it occurs in its worst form it carries a 50% death rate. The etiology and pathogenesis of this condition demonstrate that in many instances it may be prevented. Early recognition, particularly of the transmural ischemic injury, is essential. Numerous techniques used during surgery for assessing the adequacy of colonic perfusion have been evaluated and found to be cumbersome and inaccurate in terms of predicting colonic ischemia. Recent experience with the use of the pulse oximeter appears promising in identifying patients with inadequate colonic perfusion who may then be candidates for reimplantation of the inferior mesenteric artery.