Abstract
A 71-year-old man who had previously undergone a low anterior resection for rectal cancer, was admitted for surgery because of a dilated abdominal aortic aneurysm. An abdominal CT scan revealed a pararenal abdominal aortic aneurysm, with a maximum diameter of 53 mm. An abdominal aortic angiogram suggested occlusion of both the internal mesenteric artery and the internal iliac artery. A coronary artery angiogram suggested coronary triple vessel disease in combination with an old myocardial infarction. After prior coronary artery bypass grafting, abdominal aortic graft replacement with reconstruction of bilateral renal artery was performed. Because the patient developed severe ischemic colitis a day after the operation, urgent left hemicolectomy and colostomy were thus performed. He was discharged in good condition 127 days after Y-graft replacement. Patients who have previously undergone colorectal surgery are considered to be at high risk for developing colon ischemia postoperatively. We therefore suggest that careful perioperative treatment is required to prevent the development of colon ischemia in these patients.
