Acute bowel ischemia: CT findings

Angelelli, Giuseppe; Scardapane, Arnaldo; Memeo, M.; Ianora, Amato Antonio Stabile; Rotondò, Antonio

doi:10.1016/j.ejrad.2003.11.013

Cited by 70 publications

(57 citation statements)

References 26 publications

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“…Rapid and accurate diagnosis is essential to improve the prognosis and quality of life of patients with ischemic small bowel disease. Even when the latest high-technology diagnostic devices, such as multidetector computed tomography (CT), are used, these diseases are sometimes overlooked [2,3]. It remains difficult, even for experienced physicians, to identify patients at risk of bowel necrosis among patients presenting with acute abdomen.…”

Section: Introductionmentioning

confidence: 98%

Diagnosis of ischemic small bowel disease by measurement of serum intestinal fatty acid-binding protein in patients with acute abdomen: a multicenter, observer-blinded validation study

et al. 2011

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Section: Introductionmentioning

confidence: 98%

Diagnosis of ischemic small bowel disease by measurement of serum intestinal fatty acid-binding protein in patients with acute abdomen: a multicenter, observer-blinded validation study

et al. 2011

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“…It results from an abnormal blood supply to the mesenteric region, which may lead to bowel-wall necrosis [1,2]. The longer life expectancy of the general population and the resulting degenerative vascular diseases have led to a steady increase in the incidence of this disease.…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of multidetector computed tomography in bowel infarction

et al. 2009

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“…With its high spatial resolution and volumetric 3 dimensional reconstructions, multidetector CT angiography (MDCTA) allows direct non-invasive visualization of the etiology of AMI and its insults on the intestines, and associated findings/pathologies through a great anatomical detail window (6,11).…”

Section: Diagnosis Of Acute Mesenteric Ischemiamentioning

confidence: 99%

“…Mesenteric venous thrombosis is a rare, but potentially life-threatening, entity occurring more commonly in hypercoagulable states, trauma, portal hypertension, splenectomy, closed loop obstruction and inflammatory bowel disease (6,14). It accounts for 5-15% of AMI cases (7).…”

Section: Mdct Features Of Acute Mesenteric Ischemiamentioning

confidence: 99%

“…Plain radiography and ultrasound are generally initial modalities used in patients presenting with acute abdomen in an emergency room, but their role is limited in the demonstration of primary and secondary signs of AMI. On plain radiographs, dilated bowel segments with air-fluid levels, pneumatosis and portal venous gas can be seen, whereas ultrasound can demonstrate mesenteric thrombus via Doppler mode but the presence of extensive gas within bowel segments and incompliance of patients may limit the accuracy of this imaging modality (6,8,9).Digital subtraction angiography (DSA) has been regarded as the gold standard imaging method in the setting of AMI. It not only enables direct visualization of the mesenteric vasculature but also provides prompt endovascular intervention opportunity (10).…”

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confidence: 99%

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Utility of MDCT in emergency setting of acute mesenteric ischemia

Türkbey

Akpınar²,

Çil³

et al. 2008

Diagn Interv Radiol

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A cute mesenteric ischemia (AMI), which is a consequence of impaired blood flow to the gastrointestinal tract, is a life-threatening entity with an estimated mortality rate ranging between 60% and 90% (1-3). Among major etiologies of AMI are superior mesenteric artery (SMA) embolus, SMA thrombus, superior mesenteric vein (SMV) thrombosis and non-occlusive vasoconstriction (1). Minor causes of AMI include aortic dissection, intestinal volvulus, internal hernia, and adhesion band related extrinsic compression of the mesenteric vessels (4, 5). Although it is relatively rare (around 1% of all acute abdomen referrals), prompt diagnosis and treatment of AMI is important since early management of this clinical entity increases survival (6). Diagnosis of acute mesenteric ischemiaDiagnosis of AMI requires strong suspicion since the clinical features are usually non-specific such as abdominal pain, nausea, vomiting, or even diarrhea (7). Until late 1960s, surgical exploration or autopsy was used for diagnosis; then imaging modalities came into use as new diagnostic tools (8). Plain radiography and ultrasound are generally initial modalities used in patients presenting with acute abdomen in an emergency room, but their role is limited in the demonstration of primary and secondary signs of AMI. On plain radiographs, dilated bowel segments with air-fluid levels, pneumatosis and portal venous gas can be seen, whereas ultrasound can demonstrate mesenteric thrombus via Doppler mode but the presence of extensive gas within bowel segments and incompliance of patients may limit the accuracy of this imaging modality (6,8,9).Digital subtraction angiography (DSA) has been regarded as the gold standard imaging method in the setting of AMI. It not only enables direct visualization of the mesenteric vasculature but also provides prompt endovascular intervention opportunity (10). On the other hand, DSA is invasive, expensive, needs experience and, unfortunately, not readily available (10).Computed tomography (CT) became a powerful tool in the management of AMI with the introduction of multidetector technology, as it provides direct visualization of the mesenteric vasculature, intestines and mesentery (7). With its high spatial resolution and volumetric 3 dimensional reconstructions, multidetector CT angiography (MDCTA) allows direct non-invasive visualization of the etiology of AMI and its insults on the intestines, and associated findings/pathologies through a great anatomical detail window (6, 11).Magnetic resonance (MR) angiography is another non-invasive tool for the detection of AMI by determining mesenteric flow. It can be used as a second choice in children but its power is by far limited in the demonstration of calcified plaques (12, 13). ABDOMINAL IMAGING PICTORIAL ESSAY Utility of multidetector CT in an emergency setting in acute mesenteric ischemiaBarış Türkbey, Erhan Akpınar, Barbaros Çil, Muşturay Karçaaltıncaba, Okan Akhan ABSTRACT Prompt diagnosis of acute mesenteric ischemia is a dilemma which is unfortunately generally m...

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Acute bowel ischemia: CT findings

Cited by 70 publications

References 26 publications

Diagnosis of ischemic small bowel disease by measurement of serum intestinal fatty acid-binding protein in patients with acute abdomen: a multicenter, observer-blinded validation study

Diagnosis of ischemic small bowel disease by measurement of serum intestinal fatty acid-binding protein in patients with acute abdomen: a multicenter, observer-blinded validation study

Prognostic value of multidetector computed tomography in bowel infarction

Utility of MDCT in emergency setting of acute mesenteric ischemia

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