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Computed Tomography Evaluation of Small Bowel Ischemia

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CT Scan in Abdominal Emergency Surgery

Part of the book series: Hot Topics in Acute Care Surgery and Trauma ((HTACST))

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Abstract

Early and accurate diagnosis of mesenteric ischemia remains challenging due to the broad spectrum of clinical symptoms and radiological findings. Prompt diagnosis reduces and may allow for interventional radiology treatment opportunities. Computed tomography (CT) is now the first-line imaging tool for investigation of suspected acute or chronic mesenteric ischemia. However, CT has limitations and may over- or undercall mesenteric ischemia. The optimal CT protocol includes a biphasic or triphasic CT with judicious use of “neutral” oral contrast agents. An understanding of the spectrum of CT findings encountered in mesenteric ischemia is pivotal to an early diagnosis. Failure of timely CT and implementation of the optimal CT protocols may result in the patient’s death. Key radiological features vary significantly according to the etiology and severity of mesenteric ischemia. Detailed assessment of the mesenteric vessels, bowel wall thickness, mucosal enhancement patterns, and mesenteric abnormalities are required.

“Occlusion of the mesenteric vessels is apt to be regarded as one of those conditions of which the diagnosis is impossible, the prognosis hopeless, and the treatment almost useless.”

Cokkinis, 1930 [1]

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Author information

Authors and Affiliations

  1. Department of Radiology, Mater Misericordiae University Hospital, Dublin 7, Ireland

    Gavin Sugrue M.B., B.C.H., B.A.O., M.R.C.P

  2. Department of Surgery, Letterkenny University Hospital, Donegal Clinical Research Academy, Donegal, Ireland

    Michael Sugrue MB, BCh, BAO, MD, FRCSI, FRACS

Authors
  1. Gavin Sugrue M.B., B.C.H., B.A.O., M.R.C.P
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  2. Michael Sugrue MB, BCh, BAO, MD, FRCSI, FRACS
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Corresponding author

Correspondence to Gavin Sugrue M.B., B.C.H., B.A.O., M.R.C.P .

Editor information

Editors and Affiliations

  1. Emergency and Trauma Surgery, Ospedale Maggiore di Parma Emergency and Trauma Surgery, Parma, Parma, Italy

    Fausto Catena

  2. Cambridge Colorectal Unit, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, United Kingdom

    Salomone Di Saverio

  3. General, Emergency and Trauma Surgery, Department Bufalini Hospital, Cesena, Italy

    Luca Ansaloni

  4. General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy

    Federico Coccolini

  5. Department of Surgery, Macerata Hospital, Macerata, Italy

    Massimo Sartelli

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Sugrue, G., Sugrue, M. (2018). Computed Tomography Evaluation of Small Bowel Ischemia. In: Catena, F., Di Saverio, S., Ansaloni, L., Coccolini, F., Sartelli, M. (eds) CT Scan in Abdominal Emergency Surgery. Hot Topics in Acute Care Surgery and Trauma. Springer, Cham. https://doi.org/10.1007/978-3-319-48347-4_11

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  • DOI: https://doi.org/10.1007/978-3-319-48347-4_11

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  • Online ISBN: 978-3-319-48347-4

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