Radiology in Intestinal Ischemia: Plain Film, Contrast, and Other Imaging Studies

Wolf, Ellen L.; Sprayregen, Seymour; Bakal, Curtis W.

doi:10.1016/s0039-6109(16)45630-6

Cited by 81 publications

(30 citation statements)

References 38 publications

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“…They force a massof feces into the rectum, and then the desire for defecation is felt. Intestinal distention and increased intraluminal pressure are thought to be responsible for colonic ischemia (15,16). Our patient also had atrial fibrillation.…”

Section: Discussionmentioning

confidence: 66%

Development of Colonic Necrosis Following Severe Acute Pancreatitis.

Umeno¹,

Otsuka²,

Sasatomi³

et al. 2000

Intern. Med.

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Weherein describe a 70-year-old male patient who developed colonic necrosis following severe acute pancreatitis. He was referred to our hospital with a diagnosis of acute pancreatitis. In the course of the disease, he developed sudden and massive hematochezia and died. The autopsy findings revealed large bowel ischemia with transmural infarction. The possible pathogenic mechanisms of colonic ischemiaare also discussed.

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Section: Discussionmentioning

confidence: 66%

Development of Colonic Necrosis Following Severe Acute Pancreatitis.

Umeno¹,

Otsuka²,

Sasatomi³

et al. 2000

Intern. Med.

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“…Meanwhile, a multi-institutional study reported a specificity near 100% with multislice CT, overcoming the 88% specificity rate achieved by the prior gold standard diagnostic tool, DSA. [13,14] The most common biochemical pathologies in AMI patients are hemoconcentration, leukocytosis, and high anion-gap metabolic acidosis. In previous initial biochemical assessments of serum amylase, aspartate aminotransferase, LDH, and creatine phosphokinase, levels had not reached sensitivity and specificity rates sufficient to aid in diagnosis of AMI.…”

Section: Discussionmentioning

confidence: 99%

Role Of Alkaline Phosphatase Intestine-Isomerase In Acute Mesenteric Ischemia Diagnosis

Lapsekili¹,

Menteş

Balkan

et al. 2015

Ulus Travma Acil Cerrahi Derg

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“…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.…”

Section: Diagnosis 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).…”

mentioning

confidence: 99%

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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Radiology in Intestinal Ischemia: Plain Film, Contrast, and Other Imaging Studies

Cited by 81 publications

References 38 publications

Development of Colonic Necrosis Following Severe Acute Pancreatitis.

Development of Colonic Necrosis Following Severe Acute Pancreatitis.

Role Of Alkaline Phosphatase Intestine-Isomerase In Acute Mesenteric Ischemia Diagnosis

Utility of MDCT in emergency setting of acute mesenteric ischemia

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