الفهرس 
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Abstract
Colonic ischemia is a major adverse event after abdominal aortic aneurysm (AAA) repair. incidence of clinically significant colonic ischemia is in the range of 1 to 3% after elective surgery and 10% in case of rupture. When routine postoperative colonoscopy is performed, the incidence is higher.
Mesenteric ischemia after AAA repair has a multifactorial origin leading to hypoperfusion of the intestines. Patient-dependent variables are age, renal impairment, and smoking. These variables are also associated with the development of atherosclerosis leading to a higher risk of mesenteric ischemia.
Perioperative variables including aneurysm rupture, indication for surgery (ruptured vs elective), type of treatment (EVAR vs open), and operative details (duration of surgery, blood loss, inferior mesenteric artery reconstruction, site of distal anastomosis, hypogastric artery embolization or coverage). These factors could lead to intraoperative hemodynamic disturbances, making the patient more prone to develop mesenteric ischemia.
Postoperative ischemic colitis was also found to be significantly associated with increased mean hospitalization length of the affected patients, The median time of diagnosis of colonic ischemia was postoperative day 2 with the majority of patients diagnosed within the first 4 postoperative days, This is the most critical time in a patient’s hospitalization when physicians must be aware of this serious complication.
In addition, 30-day mortality was much worse in parients who developed postoperative ischemic colitis.