Background:

the high mortality of intestinal ischemia requires an effort of coordination at all levels, requiring prompt action. Segmental ischemias are less common and, more so, those of the territory of the inferior mesenteric artery.

Objective:

to present a rare case of ischemia of the rectosigmoid junction, caused by an embolism of the inferior mesenteric artery and subsequent necrosis of the upper rectal territory.

Case presentation:

76-year-old female patient admitted for 31 days with a diagnosis of cerebral infarction-type cerebrovascular disease, which on the day her discharge is decided presents a syncopal picture, presenting later; pain, abdominal distension and contracture in the lower left quadrant, so she undergoes a surgery finding a necrosis of the upper rectum and low sigmoid (recto-sigmoid union).

Conclusions:

the embolism of the inferior mesenteric artery with segmental necrosis is a very rare presentation of this affection, in the literature the cases reported are scarce, this is due to the anatomical considerations of the mesenteric arteries and veins, when occlusion of the inferior mesenteric artery occurs is usually slow and progressive with revascularization or if abruptly the superior mesenteric artery supplies the needs of this territory through the Drummont artery, which occurred in this patient but not with her terminal artery (Sudeck's critical point) recto-sigmoid necrosis.

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