The Value of Routine Flexible Sigmoidoscopy Within 48 Hours After Surgical Repair of Ruptured Abdominal Aortic Aneurysms

Accuracy of Routine Endoscopy Diagnosing Colonic Ischaemia After Abdominal Aortic Aneurysm Repair: A Meta-analysis

“…It is important to realise the mechanism of developing CI after AAA repair is multifactorial and it is suggested to be caused by ligation of the inferior mesenteric artery (IMA) with occluded or stenotic internal iliac arteries, 9,22 hypoperfusion in the acute setting and during aortic clamping, 6,14,32 and abdominal compartment syndrome. 8 Endoscopy might cause an extra risk of increased intraabdominal pressure (IAP) due to insufflation.…”

“…Variables such as age, hypotension, ligation of hypogastric artery, aortic clamping time, open repair, and many more have been described as potential risk factors. 4,6,9,27 A recent review including risk factors for CI could only identify open surgery and emergency repair as definite risk factors for CI. 5 Champagne et al 14 showed that lactate was a good marker for CI, although this is contradicted by others.…”

“…To lower the mortality after AAA repair, the early diagnosis of CI is important to allow for prompt and timely treatment of CI. 6 Different tests have been studied to determine the presence of CI but most lack specificity. 7e10 Bloody diarrhoea or early passage of stool occurred only in just over half of patients with transmural CI which makes clinical assessment very challenging.…”

Efficacy of endovascular management approach of ruptured abdominal aortic aneurysm

“…66 In a small review, 22% of the patients had some degree of colonic ischemia after repair of ruptured AAA. 67 The conversion of EVAR for open repair is unusual in elective AAA repair and, as yet, undefined with the AAA roto. Conversion of EVAR for open repair is generally associated with higher rates of mortality in comparison with the open repair.…”

Ruptured aneurysm of abdominal aorta: is surgery the best treatment?

“…Extrapolating from these findings, it appears that EVAR would be highly desirable in patients with rAAA who have poor prognosis factors for the open repair. The apparent advantage of EVAR probably relates to its minimally invasive nature, which minimizes the physiological stress and decreases the risk of cardiovascular disease, pulmonary and renal disease28 .Extended operating time, increased blood loss, increased fluid administration, and intraoperative hypotension are predictive of postoperative intestinal ischemia, which has a mortality rate of almost 60% in patients undergoing open repair of rAAA31 . In a small review of patients it was described some degree of colonic ischemia after repair of rAAA32 .Conversionof EVAR for open repair is unusual for elective AAA repair and is, as yet, undefined for rAAA.…”