Increased Attenuation of Intestinal Contents at CT Indicates Bowel                     Necrosis in Closed-Loop Small Bowel Obstruction

Li, Bing-Qi; Qi, Wei-Jun; Yuan, Meng; Wang, Hang-Yan; Chen, Ming; Song, Zi-Xiu; Li, Qi; Li, Lei; Jiang, Bin; Ma, Zhao-Lai; Xiu, Dian-Rong; Yuan, Chun-Hui

doi:10.1148/radiol.231710

Cited by 5 publications

(2 citation statements)

References 31 publications

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“…The progressive worsening of the patient's pain and abrupt onset of signs of peritonitis necessitated a reevaluation. A subsequent CT scan, conducted 2 h later, revealed exacerbated dilation of the terminal ileum and high-density shadows in the intestinal lumen indicative of intestinal necrosis[ 5 ], without significant alterations in the peri-appendiceal effusion. These findings prompted a decisive reversal of the initial diagnosis and urgent surgical exploration.…”

Section: Discussionmentioning

confidence: 99%

Misdiagnosed Meckel's diverticulum with internal hernia mimicking appendicitis: A case report

Zhang,

Xu,

et al. 2024

World J Clin Cases

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BACKGROUND Meckel's diverticulum is a common congenital anomaly of the gastrointestinal tract, with a higher incidence rate in children under 7 years old. The condition is characteristically asymptomatic but may become a clinical concern when complications such as intestinal obstruction, bleeding, perforation, or diverticulitis precipitate acute abdominal presentations. CASE SUMMARY This report describes the case of a middle-aged man initially suspected of having acute appendicitis, which rapidly progressed to acute peritonitis with concomitant intestinal obstruction observed during preoperative assessment. Surgical exploration confirmed the diagnosis of Meckel's diverticulum-induced internal hernia, accompanied by intestinal obstruction and necrosis. In addition, the hernial ring base exhibited entrapment resembling a surgical knot. CONCLUSION Meckel's diverticulum is a rare cause of small bowel obstruction in adults, and it should be considered in a differential diagnosis.

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Section: Discussionmentioning

confidence: 99%

Misdiagnosed Meckel's diverticulum with internal hernia mimicking appendicitis: A case report

Zhang,

Xu,

et al. 2024

World J Clin Cases

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“…Non-enhanced CT images are useful for detecting spontaneous bowel wall hyperdensity and/or intraluminal content hyperdensity that are suggestive of bowel ischemia [ 31 , 32 ], and to assess atherosclerotic calcifications [ 33 ]. Biphasic contrast-enhanced CT allows the easy detection of arterial and venous filling defects and bowel wall enhancement.…”

Section: Mdcta Technical Considerationmentioning

confidence: 99%

Diagnostic Role of Multi-Detector Computed Tomography in Acute Mesenteric Ischemia

Ronza,

Di Gennaro,

Buzzo

et al. 2024

Diagnostics

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Mesenteric ischemia diagnosis is challenging, with an overall mortality of up to 50% of cases despite advances in treatment. The main problem that affects the outcome is delayed diagnosis because of non-specific clinical presentation. Multi-Detector CT Angiography (MDCTA) is the first-line investigation for the suspected diagnosis of vascular abdominal pathologies and the diagnostic test of choice in suspected mesenteric bowel ischemia. MDCTA can accurately detect the presence of arterial and venous thrombosis, determine the extent and the gastrointestinal tract involved, and provide detailed information determining the subtype and the stage progression of the diseases, helping clinicians and surgeons with appropriate management. CT (Computed Tomography) can differentiate forms that are still susceptible to pharmacological or interventional treatment (NOM = non-operative management) from advanced disease with transmural necrosis in which a surgical approach is required. Knowledge of CT imaging patterns and corresponding vascular pathways is mandatory in emergency settings to reach a prompt and accurate diagnosis. The aims of this paper are 1. to provide technical information about the optimal CTA (CT Angiography) protocol; 2. to explain the CTA arterial and venous supply to the gastrointestinal tract and the relevant ischemic pattern; and 3. to describe vascular, bowel, and extraintestinal CT findings for the diagnosis of acute mesenteric ischemia.

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Dual-energy CT: Bridging the gap between innovation and clinical practice

Calame,

Mulé

2024

Diagnostic and Interventional Imaging

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Increased Attenuation of Intestinal Contents at CT Indicates Bowel Necrosis in Closed-Loop Small Bowel Obstruction

Cited by 5 publications

References 31 publications

Misdiagnosed Meckel's diverticulum with internal hernia mimicking appendicitis: A case report

Misdiagnosed Meckel's diverticulum with internal hernia mimicking appendicitis: A case report

Diagnostic Role of Multi-Detector Computed Tomography in Acute Mesenteric Ischemia

Dual-energy CT: Bridging the gap between innovation and clinical practice

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