Abstract
A 77-year-old man, presented with chest and abdominal pain, was diagnosed with aortic dissection with severe stenosis of the celiac artery and superior mesenteric artery (SMA) and obstruction of the inferior mesenteric artery and left common iliac artery on computed tomography. Replacement of the ascending aorta was performed but the entry was not resected. He underwent sigmoid colon resection and colostomy due to necrosis on postoperative day 1 (POD1). Then, the small intestinal tone returned to normal, and good flow in the SMA was observed by collar Doppler ultrasonography. However, the patient presented with extensive intestinal ischemia on POD2. Surgical treatment was not performed due to the presence of large intestinal ischemia. Then, the intestinal ischemia improved with only conservative treatment, and the intestinal appearance was found to be almost normal in exploratory laparotomy on POD10. He was transferred to another hospital for rehabilitation, and he is currently visiting our hospital as an outpatient without a sequelae.
