February 12, 2011

Small Bowel Ischemia

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
  • Strangulation
  • 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.

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