Bowel obstruction and intestinal ischemia: warnings for radiologists

  • M. A. Mazzei
  • S. GuerriniEmail author
  • G. Lucii
  • F. G. Mazzei
  • L. Volterrani
Letter to the Editor

To the Editor,

We read with great interest the article by Dr. Cox and colleagues, entitled “Bowel obstruction complicated by ischemia: analysis of CT findings”, on 173 cases of patients with surgical bowel obstruction, 37 of them complicated with bowel ischemia [1].

Bowel obstruction is a common cause of acute abdomen in the emergency setting, especially due to occlusion of the small intestine, and may complicate with bowel wall ischemia and necrosis, or perforation. Approximately, 7% to 42% of bowel obstructions could be complicated by ischemia, which can require urgent surgical intervention. We agree with the conclusion reported by Authors, stating that hypoenhancement, bowel wall thickening and pneumatosis are useful, highly specific CT signs of bowel ischemia in the setting of surgical obstruction, similar to the non-obstructive setting [1].

However, from a radiological point of view, we would like to stress two different messages for radiologists focusing on the association...



No funding was obtained for this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the local institutional review board.


  1. 1.
    Cox VL, Tahvildari AM, Johnson B, Wei W, Jeffrey RB (2018) Bowel obstruction complicated by ischemia: analysis of CT findings. Abdom Radiol (NY). 43:3227-3232.CrossRefGoogle Scholar
  2. 2.
    Hayakawa K, Tanikake M, Yoshida S, Yamamoto A, Yamamoto E, Morimoto T (2013) CT findings of small bowel strangulation: the importance of contrast enhancement. Emerg Radiol. 20:3-9. Review.CrossRefGoogle Scholar
  3. 3.
    Mazzei MA, Guerrini S, Cioffi Squitieri N, Genovese EA, Mazzei FG, Volterrani L (2012) [Diagnosis of acute mesenteric ischemia/infarction in the era of multislice CT]. Recenti Prog Med. 103:435-7. Review. Italian.
  4. 4.
    Mazzei MA, Gentili F, Volterrani L (2019) Dual-Energy CT Iodine Mapping and 40-keV Monoenergetic Applications in the Diagnosis of Acute Bowel Ischemia: A Necessary Clarification. AJR Am J Roentgenol. 212:W93-W94. Scholar
  5. 5.
    Mazzei MA, Volterrani L (2015) Nonocclusive mesenteric ischaemia: think about it. Radiol Med. 120:85-95. Review.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Medical, Surgical and Neuro Sciences, Diagnostic ImagingUniversity of Siena, Azienda Ospedaliera Universitaria SeneseSienaItaly
  2. 2.Department of Radiological Sciences, Diagnostic Imaging UnitAzienda Ospedaliera Universitaria SeneseSienaItaly

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