Irreversible lower limb ischaemia following ligation of the inferior mesenteric artery in the surgical treatment of rectal cancer.
Rectal cancer and cardiovascular disease are both commoner in the elderly and may coexist. In some severe arteriopaths the blood supply to the lower limbs may be a collateral circulation from the inferior mesenteric artery. Patients with aorto-iliac occlusion or severe stenosis may have collaterals from the inferior mesenteric artery to the lower limb blood vessels. Ligation of the inferior mesenteric artery in treating rectal cancer can result in irreversible ischaemia as outlined in this report. Routine palpation of the femoral pulses and awareness of collateral circulation may avoid the disastrous consequences seen in the two cases described.
Perricone
V
V
Department of General Surgery, The North Hampshire Hospital, Aldermaston Road, Basingstoke, RG24 9NA, United Kingdom.
Finnis
D
D
Ward
A S
AS
Heald
R J
RJ
Moran
B J
BJ
D000368:Aged; D000369:Aged, 80 and over; D001018:Aortic Diseases / Q000150:complications; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000601:surgery*; D003082:Colectomy / Q000009:adverse effects*; D003097:Collateral Circulation; D017809:Fatal Outcome; D006801:Humans; D007083:Iliac Artery; D007511:Ischemia / Q000209:etiology*; D008026:Ligation / Q000009:adverse effects; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D017537:Mesenteric Artery, Inferior / Q000503:physiopathology / Q000601:surgery*; D012004:Rectal Neoplasms / Q000150:complications / Q000601:surgery*