Incidence and clinical presentation of bowel ischaemia after aortoiliac surgery--2930 operations from a population-based registry in Sweden.
OBJECTIVE
To study the incidence and clinical presentation of intestinal ischaemia after aortoiliac/femoral surgery, and to validate a vascular registry concerning a serious complication.


METHODS
In the Swedish Vascular Registry (SWEDVASC) the outcome and complications of all vascular procedures are registered prospectively.


METHODS
All 2930 patients operated in 1987-93 were analysed for notified complications. A 5% random sample of all patients and a 20% random sample of fatal cases were analysed for un-notified complications. Of 415 requested patient records 413 were analysed.


RESULTS
The estimated incidence of bowel ischaemia was 2.8%. Among patients operated on for a ruptured aneurysm in shock it was 7.3%. Of the 63 patients with intestinal ischaemia only 15 presented with early passage of bloody stools. In 60 patients (95%) the lesion affected the left colon within the reach of a sigmoidoscope. Bowel ischemia was unnotified only in fatal cases, the estimated un-notified complication rate was 0.7%.


CONCLUSIONS
The incidence in this study on unselected patients did not differ from previous reports from specialised centres. Diagnosis is difficult and justifies a high index of suspicion and early use of sigmoidoscopy. The validity of the SWEDVASC registry was confirmed by a high report-rate for this complication.
Björck
M
M
Department of Surgery, Skellefteå District Hospital, Sweden.
Bergqvist
D
D
Troëng
T
T
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery; D017091:Colitis, Ischemic / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D017543:Iliac Aneurysm / Q000601:surgery*; D015994:Incidence; D007511:Ischemia / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D011897:Random Allocation; D012007:Rectum / Q000098:blood supply*; D012042:Registries; D012494:Sampling Studies; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology