Acute gastrointestinal complications of infrarenal aortic aneurysm repair

Acute gastrointestinal complications developed in 31 of 472 patients following aortic aneurysmectomy (6.6 per cent). In order of frequency these were: ischaemic intestine in nine patients, mechanical or paralytic ileus in eight patients, peptic ulceration in seven patients, undiagnosed gastrointestinal bleeding in five patients and paraprosthetic fistula in two patients. The risk of developing peptic ulcer complications was not significantly increased in patients with a previous history of peptic ulcer disease. The risk of developing an ischaemic intestine was increased if the distal limb of a prosthesis was anastomosed directly to the external iliac artery. The associated mortality was high and 21 (67.7 per cent) patients died. 33.3 per cent of the mortality occurring with elective aneurysm resection was associated with gastrointestinal complications.