Abstract
Background. Ischaemic colitis is an infrequent, but potentially fatal, complication of abdominal aortic surgery. Its presentation is often underestimated on account of a paucity of symptoms, thus the real incidence of ischaemic colitis may be higher. Aim. To determine the prognostic value and sensitivity of endoscopy, early postoperative endoscopic findings were evaluated. Methods. Over a period of three years a prospective study was undertaken in a consecutive series of 105 patients (mean age 68.9 years, range 51-85) undergoing routine rectosigmoidoscopy within 72 hours of aortic reconstructive surgery. Results. Colonic ischaemia was found in 12 patients (11.4%); five had endoscopic evidence of mild ischaemic colitis, ulcerations were identified in five and diffuse superficial necrosis in two. Seven of the 12 patients were symptomatic. Laparotomy was never deemed necessary and all patients were successfully treated with a conservative regimen. There were no deaths. Elective reconstruction or urgent procedure did not correlate with the development of colonic ischaemia, nor did duration of aortic cross-clamp time, patency of the inferior mesenteric artery and its possible legation or reimplantation or patency of the hypogastric arteries. Conclusions. Rectosigmoidoscopy is effective for early diagnosis of ischaemic colitis. Early endoscopy should be routinely performed only for patients in whom impaired blood flow is suspected on the basis of the intraoperative objective assessment of the colon and in presence of symptoms.
| Original language | English |
|---|---|
| Pages (from-to) | 357-360 |
| Number of pages | 4 |
| Journal | Italian Journal of Gastroenterology and Hepatology |
| Volume | 29 |
| Issue number | 4 |
| Publication status | Published - 1997 |
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Keywords
- Aortic aneurysm
- Aortic surgery
- Ischaemic colitis
- Postoperative rectosigmoidoscopy
ASJC Scopus subject areas
- Gastroenterology
Cite this
Is endoscopy useful for early diagnosis of ischaemic colitis after aortic surgery? Results of a prospective trial. / Fanti, L.; Masci, E.; Mariani, A.; Chiesa, R.; Jannello, A.; Melissano, G.; Castellano, R.; Guerini, S.; Tittobello, A.
In: Italian Journal of Gastroenterology and Hepatology, Vol. 29, No. 4, 1997, p. 357-360.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Is endoscopy useful for early diagnosis of ischaemic colitis after aortic surgery? Results of a prospective trial
AU - Fanti, L.
AU - Masci, E.
AU - Mariani, A.
AU - Chiesa, R.
AU - Jannello, A.
AU - Melissano, G.
AU - Castellano, R.
AU - Guerini, S.
AU - Tittobello, A.
PY - 1997
Y1 - 1997
N2 - Background. Ischaemic colitis is an infrequent, but potentially fatal, complication of abdominal aortic surgery. Its presentation is often underestimated on account of a paucity of symptoms, thus the real incidence of ischaemic colitis may be higher. Aim. To determine the prognostic value and sensitivity of endoscopy, early postoperative endoscopic findings were evaluated. Methods. Over a period of three years a prospective study was undertaken in a consecutive series of 105 patients (mean age 68.9 years, range 51-85) undergoing routine rectosigmoidoscopy within 72 hours of aortic reconstructive surgery. Results. Colonic ischaemia was found in 12 patients (11.4%); five had endoscopic evidence of mild ischaemic colitis, ulcerations were identified in five and diffuse superficial necrosis in two. Seven of the 12 patients were symptomatic. Laparotomy was never deemed necessary and all patients were successfully treated with a conservative regimen. There were no deaths. Elective reconstruction or urgent procedure did not correlate with the development of colonic ischaemia, nor did duration of aortic cross-clamp time, patency of the inferior mesenteric artery and its possible legation or reimplantation or patency of the hypogastric arteries. Conclusions. Rectosigmoidoscopy is effective for early diagnosis of ischaemic colitis. Early endoscopy should be routinely performed only for patients in whom impaired blood flow is suspected on the basis of the intraoperative objective assessment of the colon and in presence of symptoms.
AB - Background. Ischaemic colitis is an infrequent, but potentially fatal, complication of abdominal aortic surgery. Its presentation is often underestimated on account of a paucity of symptoms, thus the real incidence of ischaemic colitis may be higher. Aim. To determine the prognostic value and sensitivity of endoscopy, early postoperative endoscopic findings were evaluated. Methods. Over a period of three years a prospective study was undertaken in a consecutive series of 105 patients (mean age 68.9 years, range 51-85) undergoing routine rectosigmoidoscopy within 72 hours of aortic reconstructive surgery. Results. Colonic ischaemia was found in 12 patients (11.4%); five had endoscopic evidence of mild ischaemic colitis, ulcerations were identified in five and diffuse superficial necrosis in two. Seven of the 12 patients were symptomatic. Laparotomy was never deemed necessary and all patients were successfully treated with a conservative regimen. There were no deaths. Elective reconstruction or urgent procedure did not correlate with the development of colonic ischaemia, nor did duration of aortic cross-clamp time, patency of the inferior mesenteric artery and its possible legation or reimplantation or patency of the hypogastric arteries. Conclusions. Rectosigmoidoscopy is effective for early diagnosis of ischaemic colitis. Early endoscopy should be routinely performed only for patients in whom impaired blood flow is suspected on the basis of the intraoperative objective assessment of the colon and in presence of symptoms.
KW - Aortic aneurysm
KW - Aortic surgery
KW - Ischaemic colitis
KW - Postoperative rectosigmoidoscopy
UR - http://www.scopus.com/inward/record.url?scp=0031441778&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0031441778&partnerID=8YFLogxK
M3 - Article
C2 - 9476191
AN - SCOPUS:0031441778
VL - 29
SP - 357
EP - 360
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
IS - 4
ER -