PAEA Surgery End Of Rotation (EOR) Practice Exam

Which artery is often sacrificed during AAA repair, potentially leading to colonic ischemia?

1. Superior mesenteric artery

2. Inferior mesenteric artery

3. Renal artery

4. Common iliac artery

The correct answer is: Inferior mesenteric artery

The inferior mesenteric artery plays a crucial role in supplying blood to the distal colon. During abdominal aortic aneurysm (AAA) repair, surgical techniques may require clamping or division of the aorta, which can affect the blood supply to regions that rely on the inferior mesenteric artery. If this artery is compromised or not adequately revascularized during surgery, there is a risk of colonic ischemia in the sections of the bowel that it supplies, particularly in the sigmoid colon and rectum. The potential for colonic ischemia stems from the fact that the blood flow to these areas becomes severely diminished, as other collateral vessels may not suffice to maintain adequate perfusion. Understanding this risk is important in the context of AAA repair, where preserving blood flow to the gastrointestinal tract is a fundamental consideration in surgical planning and execution. In contrast, other arteries mentioned, such as the superior mesenteric artery, renal artery, and common iliac artery, are not primarily responsible for supplying the colon to the same extent as the inferior mesenteric artery during AAA repairs, making their involvement in colonic ischemia less likely in this specific surgical context.