An axial CT image shows a segment of decreased enhancement of the small bowel wall (arrows) as compared to the more normally enhancing loops (arrowheads).
Diminished Enhancement of Small Bowel Wall
- Better to appreciate when the bowel is filled with neutral contrast agent
- Pathognomonic for intestinal ischemia in a correct clinical setting
- To detect, it is important to compare the loops that show decreased enhancement with the more normally enhancing loops
Causes of Small Bowel Ischemia
- Low-flow states (arrhythemia, sepsis, shock)
- Embolus or thrombosis of superior mesenteric artery (SMA)
- Superior mesenteric vein (SMV) thrombosis
Our case: small bowel ischemia due to strangulated obstruction.
Macari et al. A pattern approach to abnormal small bowel: observation at MDCT and CT enterography. AJR 2007; 188:1344-1355.