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Computed Tomography Evaluation of Small Bowel Ischemia

  • Gavin Sugrue
  • Michael Sugrue
Chapter
Part of the Hot Topics in Acute Care Surgery and Trauma book series (HTACST)

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.

Keywords

Bowel Intestinal ischemia Acute mesenteric ischemia Chronic mesenteric ischemia Computed tomography Multiphase computed tomography Acute abdomen Emergency surgery 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of RadiologyMater Misericordiae University HospitalDublin 7Ireland
  2. 2.Department of SurgeryLetterkenny University Hospital, Donegal Clinical Research AcademyDonegalIreland

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