Surgical management of abdominal aortic aneurysm with coexistent intestinal disease

The management of patients suffering from abdominal aortic aneurysms with concomitant intestinal disease is demanding. Surgical procedures have to be evaluated meticulously with regard to morbidity and priority. We retrospectively investigated early and late results of nine patients (eight males, one female) with coincidental aortic and intestinal surgery during the last 9.5 years. The average age was 77 years (range 67-85). One-stage procedures were undertaken twice with implantation of aortic grafts to replace abdominal aortic aneurysms (AAA). During these emergency procedures, an aortoduodenal fistula was repaired in one case and resection of an ischemic segment of the sigmoid colon was resected in another. Seven two-stage procedures were performed as elective surgery. Five AAA were excluded before the intestinal repair. In two cases of urgent visceral pathologies, colon resection was done first, followed by elimination of the AAA. In case of elective surgery, two-stage procedures seem to be safe and effective. However, in certain emergent cases, one-stage procedures with implantation of vascular grafts in combination with colon or bowel surgery might also be justified.