Infarcts and ischemia in the abdomen: an imaging perspective with an emphasis on cross-sectional imaging findings

Abstract

Infarcts and ischemia of abdominal organs may present with acute abdominal pain, and early diagnosis is crucial to prevent morbidity and mortality. Unfortunately, some of these patients present in poor clinical conditions to the emergency department, and imaging specialists are crucial for optimal outcomes. Although the radiological diagnosis of abdominal infarcts is often straightforward, it is vital to use the appropriate imaging modalities and correct imaging techniques for their detection. Additionally, some non-infarct-related abdominal pathologies may mimic infarcts, cause diagnostic confusion, and result in delayed diagnosis or misdiagnosis. In this article, we aimed to outline the general imaging approach, present cross-sectional imaging findings of infarcts and ischemia in several abdominal organs, including but not limited to, liver, spleen, kidneys, adrenals, omentum, and intestinal segments with relevant vascular anatomy, discuss possible differential diagnoses and emphasize important clinical/radiological clues that may assist radiologists in the diagnostic process. Graphical abstract

Woman with epigastric pain after massage

“…3 features demonstrating a triangular-shaped, fat-containing heterogeneous mass between the abdominal wall and the viscera. 4 Treatment includes conservative and surgical management. A trial of conservative management initially coupled with appropriate imaging should be recommended within the first 24-48 hours.…”

“…The diagnosis is challenging due to unfamiliarity, and the nonspecific nature of symptoms 3 . However, CT is now considered the gold standard for preoperative diagnosis with typical features demonstrating a triangular‐shaped, fat‐containing heterogeneous mass between the abdominal wall and the viscera 4 . Treatment includes conservative and surgical management.…”