[Surgical strategy in the association: aneurysm of the abdominal aorta and colonic lesion].

An association of an aneurysm of the abdominal aorta and a lesion of the colon raises an important question as to the correct sequence to follow. A simultaneous operation raises the major risk of infection and most authors prefer a sequential approach, treating either the aneurysm or the lesion of the colon first depending on the initial clinical situation or complications. In our first patient, both pathologies were known before surgery and simultaneous procedures were deliberately programmed. In the second case, both lesions were complicated and required simultaneous cure. In the third case, both were recognized before surgery and a sequential approach was followed--colon then abdominal aorta. In the fourth case, the colon disease was complicated and responded to medical treatment; three months later surgery was performed on the aneurysm followed by a colectomy two months later. A review of the literature and an analysis of our four cases offer a means of developing a management strategy for patients with an aneurysm of the abdominal aorta associated with a lesion of the colon.