Mesenteric ischaemia ocurring as a late complication after-aorto-femoral bypass

Patients with coexisting peripheral vascular disease and coronary artery disease constitute a high risk surgical group. Perioperative management of such patients is an anaesthetic challenge. A 57-year-old male presented with critical limb ischaemia and impending gangrene of the right lower limb. Associated coronary artery disease with triple vessel involvement was diagnosed on coronary angiography. This patient underwent an aorto-femoral bypass. The postoperative course was complicated by the development of mesenteric ischaemia requiring emergency laparotomy and bowel resection.