Abstract
A 44-year-old man with Marfan syndrome underwent total aortic graft replacement including Bentall's procedure and reconstruction of the visceral branches 10 years previously. He was brought by ambulance because of abdominal pain high fever with diarrhea and tarry stool. We performed emergency laparotomy on the suspicion of intestinal ischemia. Intestinal necrosis with perforation was recognized, from the ascending colon to the transverse colon. We diagnosed ischemic necrotic colitis due to arterial thrombosis because pulsation of the superior mesenteric artery and celiac artery was not clear. We performed right hemicolectomy and splenectomy, plus retrograde mesenteric and celiac bypass by a saphenous vein graft. The patient's postoperative course was uneventful. Postoperative angiography revealed thrombotic occlusion of the celiac and superior mesenteric arteries.
