Q: 78 year old male with Abdominal Endovascular Aneurysm Repair (EVAR) in the morning for his Abdominal Aortic Aneurysm (AAA) complained of acute abdomen and diagnosed with acute ischemic colitis. Patient is taken to OR for emergent surgery and required colectomy. Primary anastomosis should be performed and abdomen should be closed to avoid vascular graft infection?

A) True
B) False


Answer: False (B)

On the contrary, in patients with  with an aortic or iliac vascular graft, primary anastomosis should be avoided because any subsequent anastomotic leak would contaminate the graft. As per clinical situation, abdomen can be left open and should be taken within 24 hours for second-look procedure.


Reference:

1. Betzler M. [Surgical technical guidelines in intestinal ischemia]. Chirurg 1998; 69:1.

2. Hanisch E, Schmandra TC, Encke A. Surgical strategies -- anastomosis or stoma, a second look -- when and why? Langenbecks Arch Surg 1999; 384:239.