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Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The therapeutic measure against concomitant intraabdominal aneurysm and colorectal carcinoma is still a dilemma. Here we report the clinical courses of three cases of colorectal carcinoma coincidental with moderate-sized abdominal aortic or iliac artery aneurysm in those who underwent operations during a recent three-year period. Resection of malignant lesion and wrapping of aneurysm were carried out in all three patients simultaneously. Carcinoma was staged by Dukes classification as A in one patient and B in two patients. All tolerated surgery well without any signs of complications. Two-year or three-year follow-up shows that they have continued to do well, with no further symptoms of abdominal aortic aneurysm, peripheral vascular disease, or recurrence of colorectal carcinoma. We conclude that, if the aneurysm is not about to rupture and the carcinoma is in an advanced stage, then the carcinoma should be resected, associated with interim aneurysmal wrapping. However, both lesions need to be resected eventually for long-term survival.
Dis Colon Rectum 1992 Oct
PMID:Role of wrapping in concomitant intra-abdominal aneurysm and colorectal carcinoma. Report of three cases. 139 89

Colon infarction is a lethal complication of ruptured abdominal aortic aneurysm. We compared multiple anatomic, hemodynamic, and clinical features in 25 patients with ruptured abdominal aortic aneurysm who suffered colon ischemia and 25 initial survivors of ruptured abdominal aortic aneurysm in whom this complication did not develop. Prior impressions notwithstanding, preoperative shock or volume administration did not correlate with the development of colon ischemia, nor did aneurysm location, cross-clamp site, graft type, or inferior mesenteric artery patency. However, patients with colon ischemia had a significantly lower perioperative cardiac output and were significantly more likely to have received alpha-adrenergic vasoconstrictor agents. Seventeen patients (68%) with colon ischemia died compared with nine patients (36%) without colon ischemia. Perioperative maintenance of cardiac output and avoidance of alpha-adrenergic vasopressor agents are critical elements in prevention of this lethal complication.
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PMID:Colon infarction after ruptured abdominal aortic aneurysm. 164 42

The inferior mesenteric artery (IMA) is the nutrient artery for the descending colon. Colon ischemia after repair of abdominal aortic aneurysm (AAA) can be prevented by routine or elective revascularization of the IMA. In case of occlusion of the IMA, revascularization of the internal iliac artery (IIA) has been recommended but its effectiveness has never been documented. In this study, intraoperative hemodynamic monitoring of the IMA was performed to determine if the IIA contributed significantly to the region supplied by the IMA. From January 1998 to August 1999, a total of 223 patients underwent AAA repair at 11 vascular surgery centers. The IMA was occluded in 113 of these patients (51%). This study involves the other 110 patients (49%) with patent IMA. Study consisted of measuring residual systolic arterial pressure in the IMA (IMAP) immediately after AAA repair. To compensate for blood pressure variations, systolic pressure in the radial artery (RAP) was measured concurrently and the inferior mesenteric index (P) was calculated by dividing IMAP by RAP. Measurements were made before and during cross-clamping of the IIA to obtain two corresponding indexes-i.e., P1 and P2, respectively. Mean P1 and P2 were 0.61 (95% confidence interval, 0.8-0.4) and 0.58 (95% confidence interval, 0.55-0.61), respectively, with p
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PMID:Do internal iliac arteries contribute to vascularization of the descending colon during abdominal aortic aneurysm surgery? An intraoperative hemodynamic study. 1126 80

Colon cast passage, which is the spontaneous passage of a full-thickness, infarcted colonic segment per rectum, is a rare occurrence. The main cause is acute ischemic colitis resulting from a circulation compromise. Most of the colon cast cases reported were secondary to abdominal aortic aneurysm repairs or colorectal surgery. We report a case of an 80-year-old woman with ischemic colitis who excreted a 20-cm colon cast. In most cases that involve a colon cast containing a muscle layer component, invasive therapy is required owing to colonic obstruction or stenosis. However, in the present case, the colon cast consisted only of a mucosa layer and was not associated with severe stenosis or obstruction; therefore, it was successfully treated by conservative therapy. Histologic examination of the colon segment may be crucial in determining the appropriate treatment.
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PMID:Passage of a sigmoid colon cast in a patient with ischemic colitis. 2521 11

Colon ischemia following aortic reconstruction is a severe complication with an incidence of 1% to 2% of the operated patients; this infrequent complication will be lethal for nearly half of these patients. Commonly, colon ischemia may be an intraoperative observation or an early postoperative finding. However, in the case presented here, sigmoid rupture and small and large intestine communication was revealed 3 months following repair of the abdominal aorta. A 71-year-old man, following open repair of an abdominal aortic aneurysm, went home on the fifth postoperative day. Four months later, he was admitted to the emergency department of our hospital, because of fever, diarrhea, and abdominal pain for about 5 days. After conservative treatment and improvement in symptoms, the patient was released only to return to hospital with the same symptoms after a month. On this second admission, the symptoms were initially mild and the patient seemed to improve, but suddenly he deteriorated and an exploratory laparotomy was conducted, which revealed a left colon ischemia and a communication between the sigmoid and the small intestine. A left hemicolectomy was performed, along with a temporary colostomy (Hartmann diversion). The patient, 2 years after the initial aortic repair and 10 months following the complete restoration of the large intestine continuity, is well with no further manifestations.
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PMID:Delayed Sigmoid Ischemic Rupture Following Open Repair Abdominal Aortic Aneurysm. 2867 8