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.

Reference:

Macari et al. A pattern approach to abnormal small bowel: observation at MDCT and CT enterography. AJR 2007; 188:1344-1355.