Total bowel ischemia after carbon dioxide angiography in a patient with inferior mesenteric artery occlusion.

A 70-year-old man with a history of hypertension and chronic renal failure experienced claudication in his left leg. He was treated by endovascular stenting in his left leg. We used CO2 angiography to prevent contrast-induced nephropathy. After the procedure, livedo vasculitis and lactic acidosis developed. We diagnosed the patient with CO2-induced ischemic colitis, after which we changed his position and administered conservative therapy. Contrast-enhanced computed tomography showed total bowel ischemia and total occlusion at the ostium of the inferior mesenteric artery. This rare complication after CO2 angiography might be related to the atherosclerotic occlusion of the inferior mesenteric artery.