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Arterial insufficiency to the colon and rectum followed by ischemic necrosis of this bowel portion is considered to be a rare complication after resection of abdominal aortic aneurysms and alloplastic replacement of the abdominal aorta in arterial occlusive disease. The main symptom is diarrhea and mucus or blood in stool. Sigmoidoscopic examination is of diagnostic value; the treatment of choice has to be colostomy and resection. A causative factor for the development of large bowel necrosis is diminution of collateral blood supply, which is discussed in detail.
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