Colonic ischemia after aorto-iliac surgery.

Post-operative colonic ischemia represents a major complication of aorto-iliac surgery. The cause is a low output with a variable combination of a systemic low output and loco-regional low output secondary to atherosclerotic or surgical lesions of the inferior mesenteric artery. The pre-operative angiographic work-up, evaluation of the colonic ischemic risk, per-operatively, revascularization of the inferior mesenteric artery, preservation of the hypogastric flow, control of stable systemic hemodynamics, have significantly diminished the incidence of severe colonic ischemia while systematic colonoscopy at the slightest evocative symptom has permitted an effective treatment. The mortality is therefore greatly reduced. When the colonic ischemia is part of an acute circulatory failure, it is only one factor among other visceral ischemias, and it is the same for pelvic ischemias. In these 2 eventualities, the prognosis remains latent.