Gangrenous ischaemic colitis following lung wedge resection

A 77-year-old man, who was taking prednisolone 7.5 mg, underwent wedge resection for nodules in the right lower lobe of the lung. The nodules were diagnosed as amyloid tumour. On the sixth postoperative day, sudden tachycardia, fever, creatine phosphokinase increase, renal dysfunction and metabolic acidosiswere observed. CT showed no signs of infection, exacerbation of interstitial pneumonia, pulmonary embolism or occlusion in the major vessels of the mesentery. Exploratory laparotomyrevealed intestinal necrosis in the inferior mesenteric arteryarea, and left hemicolectomywas performed. Postoperative pathological examination revealed gangrenousischaemic colitis. Although gangrenousischaemic colitisis not a complication specific to general thoracic surgery, it can be fatal. Because of the high risk of developing gangrenousischaemic colitisin elderly patients and the increase in concomitant diseases, thoracic surgeonsshould always be mindful of the condition.