Ischaemic colitis and abdomino-perineal excision

Two patients are presented in whom ischaemic colitis followed some years after abdomino-perineal excision of the rectum for carcinoma. The first patient was a young man without evidence of arterial disease and the second patient suffered from auricular fibrillation, thought to be due to ischaemic heart disease. Ligation of the inferior mesenteric artery in the operation of abdomino-perineal excision of the rectum may reduce the blood flow through the marginal artery of Drummond rendering the remaining colon more liable to ischaemic damage. Patients who pass bright blood through a colostomy following abdomino-perineal excision of the rectum for carcinoma may have ischaemic colitis rather than a recurrence of the neoplasm.