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A rare complication in elective repair of an abdominal aortic aneurysm: Multiple transmural colonic infarcts secondary to atheroemboli

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Annals of Vascular Surgery

Abstract

Numerous complications may occur during elective and emergency repair of abdominal aortic aneurysms. The following report will document a rare complication in a patient with chronic renal failure. Multiple atheroemboli were found to produce transmural infarction of the left colon after elective repair of an abdominal aortic aneurysm. The pathologic process and the proposed mechanism of injury are also discussed.

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References

  1. Wittenstein GJ. Complications of aortic anemysm surgery: Prevention and treatment. Thorac Cardiovasc Surg 1987;35: 136–139 (special issue).

    PubMed  Google Scholar 

  2. Hagihara PF, Ernst CB, Griffen WD Jr. Incidence of ischemic colitis following abdominal aortic reconstruction. Surg Gynecol Obstet 1979;149:571–573.

    PubMed  Google Scholar 

  3. Kim MW, Hundahl SA, Dang CR, et al. Ischemic colitis after aortic aneurysmectomy. Am J Surg 1983;145:392–394.

    PubMed  Google Scholar 

  4. Maupin GE, Rimar SD, Villalba M. Ischemic colitis following abdominal aortic reconstruction for ruptured aneurysm. Am Surg 1989;55:378–380.

    PubMed  Google Scholar 

  5. Speakman MJ, Tumbull AR. Passage of a colon “cast” following resection of an abdominal aortic aneurysm. Br J Surg 1984;71:935.

    PubMed  Google Scholar 

  6. Baxter BT, McGee GS, Flinn WR, et al. Distal embolization as a presenting symptom of aortic aneurysms. Am J Surg 1990;160:197–201.

    PubMed  Google Scholar 

  7. Moolenaar W, Kreuning J, Eulderink F, et al. Ischemic colitis and acalculous necrotizing cholecystitis as rare manifestations of cholesterol emboli in the same patient. Am J Gastroenterol 1989;84:1421–1422.

    PubMed  Google Scholar 

  8. Godeau P, Herreman G, Prost de Y, et al. Perforation du sigmoïde au cours d'embolie de cholestérol simulant une périantérite noueuse. Sem Hop Paris 1979;55:951–954.

    PubMed  Google Scholar 

  9. Kaufman JL, Stark K, Brolin RE. Disseminated atheroembolism from extensive degenerative atherosclerosis of the aorta. Surgery 1987;102:63–70.

    PubMed  Google Scholar 

  10. Piccinini E, Turicchia GU, Altini R, et al. Prevención de la isquemia colónica durante la cirugia de aorta. Angiologia 1990;42:112–114.

    PubMed  Google Scholar 

  11. Nelson J, Ormrod DJ, Miller TE. Host immune status in uremia. IV. Phagocytosis and inflammatory response in vivo. Kidney Int 1983;23:312–319.

    PubMed  Google Scholar 

  12. Nsouli KA, Lazarus JM, Schoenbaum SC, et al. Bacteremic infection in hemodialysis. Arch Intern Med 1979; 139:1255–1258.

    PubMed  Google Scholar 

  13. Brogan TD. Phagocytosis by polymorphonuclear leucocytes from patients with renal failure. Br Med J 1967;3:596–599.

    Google Scholar 

  14. Montgomerie JZ, Kalmanson GM, Guze LB. Leukocyte phagocytosis and serum bactericidal activity in chronic renal failure. Am J Med Sci 1972;264:385–393.

    PubMed  Google Scholar 

  15. Burleson RL. Reversible inhibition of phagocytosis in anephric uremic patients. Surg Forum 1973;24:75–77.

    PubMed  Google Scholar 

  16. Salant DJ, Glover AM, Anderson R, et al. Depressed neutrophil chemotaxis in patients with chronic renal failure and after renal transplantation. J Lab Clin Med 1976;88:536–545.

    PubMed  Google Scholar 

  17. Goldblum SE, Van Epps DE, Reed WP. Serum inhibitor of C5 fragment-mediated polymorphonuclear leukocyte chemotaxis associated with chronic hemodialysis. J Clin Invest 1979;64:255–264.

    PubMed  Google Scholar 

  18. Abrutyn E, Solomons NW, St Clair L, et al. Granulocyte function in patients with chronic renal failure: Surface adherence, phagocytosis, and bactericidal activity in vitro. J Infect Dis 1977;135:1–8.

    PubMed  Google Scholar 

  19. Alexiewicz JM, Smogorzewski M, Fadda GZ, et al. Impaired phogocytosis in dialysis patients: Studies on mechanisms. Am J Nephrol 1991;11:102–111.

    PubMed  Google Scholar 

  20. Doherty CC, LaBelle P, Collins JF, et al. Effect of parathyroid hormone on random migration of human polymorphonuclear leukocytes. Am J Nephrol 1988;8:212–219.

    PubMed  Google Scholar 

  21. Massry SG, Schaefer RM, Teschner M, et al. Effect of parathyroid hormone on elastase release from human polymorphonuclear leucocytes. Kidney Int 1989;36:883–890.

    PubMed  Google Scholar 

  22. Smogarzewski M, Koureta P, Fadda GZ, et al. Chronic excess of parathyroid hormone (PTH) increases cytosolic calcium (CC) of brain synaptosomes in the presence or absence of chronic renal failure. Kidney Int 1990;37:470.

    Google Scholar 

  23. Perna AF, Fadda GZ, Zhore XJ, et al. Mechanisms of the impaired insulin secretion after chronic excess of parathyroid hormone. Am J Physiol 1990;259:F210-F216.

    PubMed  Google Scholar 

  24. Baczynski R, Massry SG, Kohan R, et al. Effect of parathyroid hormone on myocardial energy metabolism in the rat. Kidney Int 1985;27:718–725.

    PubMed  Google Scholar 

  25. Baczynski R, Massry SG, Magott M, et al. Effect of parathyroid hormone on energy metabolism of skeletal muscle. Kidney Int 1985;28:722–727.

    PubMed  Google Scholar 

  26. Lew DP, Andersson T, Hed J, et al. Ca2+-dependent phagocytosis in human neutrophils. Nature 1985;315:509–511.

    PubMed  Google Scholar 

  27. DiVirgilio F, Meyer BC, Greenberg S, et al. Fc receptormediated phagocytosis occurs in macrophages at exceedingly low cytosolic Ca2+ levels. J Cell Biol 1988;106:657–666.

    PubMed  Google Scholar 

  28. Bast TJ, van der Biezen JJ, Scherpenisse J, et al. Ischemic disease of the colon and rectum after surgery of an abdominal aortic aneurysm: A prospective study of the incidence and risk factors. Eur J Vasc Surg 1990;4:253–257.

    PubMed  Google Scholar 

  29. Degoulet P, Legrain M, Réach I, et al. Mortality risk factors in patients treated by chronic hemodialysis. Nephron 1982;31: 103–110.

    PubMed  Google Scholar 

  30. Kamovsky ML. Metabolic basis of phagocytic activity. Physiol Rev 1962;42:143–168.

    PubMed  Google Scholar 

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Bayne, S.R., Donovan, D.L. & Henthorne, W.A. A rare complication in elective repair of an abdominal aortic aneurysm: Multiple transmural colonic infarcts secondary to atheroemboli. Annals of Vascular Surgery 8, 290–295 (1994). https://doi.org/10.1007/BF02018178

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