Nonocclusive mesenteric ischemia is a poorly understood process that infrequently complicates states of hemodynamic compromise. The right side of the colon appears to be particularly sensitive to this pathologic event. In a 25-year-old man, spinal shock from a gunshot injury to the thoracic spinal cord resulted in right colon necrosis from nonocclusive mesenteric ischemia. The anatomic and physiologic characteristics of the mesenteric circulation to the right colon that lead to this risk for nonocclusive mesenteric ischemia were studied.