[ XXXX after vascular reconstruction of an abdominal aortic aneurysm].

@entity1 @entity712 @entity1755 @entity39 @entity63 @entity294 @entity31 @entity5132 @entity281 @entity733 @entity955 @entity490
HISTORY AND CLINICAL FINDINGS: A 60-year-old @entity1 had a dacron aortofemoral bypass graft inserted to replace a ruptured infrarenal @entity1755 . He subsequently had tachyarrhythmic @entity955 with @entity712 , NYHA class IV, and diffuse @entity490 associated with watery @entity294 . INVESTIGATIONS: Stool tests merely demonstrated @entity5132 . Abdominal ultrasound revealed intestinal loops with thickened walls and decreased peristalsis. Coloscopy demonstrated a retroperitoneal intestinal perforation with @entity733 formation resulting from @entity31 which had also uncovered the vascular prosthesis near the @entity733 . DIAGNOSIS: Ischemic transmural @entity39 with retroperitoneal intestinal perforation. TREATMENT AND COURSE: The rectosigmoid colon was resected and an end-colostomy made with closure of the rectal stump (Hartmann's operation). The uncovered right limb of the vascular graft was covered completely and was discharged, being now mobile using a walking frame. There was no evidence of @entity281 in the dacron prosthesis. CONCLUSION: A transmural progression of an @entity63 should be considered as a late sequela after emergency vascular reconstruction of the abdominal aorta. Even if symptoms are mild, early postoperative sigmoidoscopy is indicated.
