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Ten patients undergoing elective infrarenal aortic surgery were studied. Samples were taken perioperatively from a sigmoid tonometer to determine intramucosal pH (pHi) of the sigmoid colon, and simultaneously venous blood was taken for endotoxin measurement. Colonoscopy and biopsy were performed preoperatively and one week postoperatively. Significant endotoxemia was detected in 5 patients (50%), all of whom had transient colonic ischemia on the basis of tonometry, and of whom 2 had histologic evidence of ischemia at one week. Endotoxemia does occur during aortic surgery and appears to be associated with colonic ischemia, though this requires further evaluation.