Ischemic Bowel Disease and Vasculitis

Abstract

Ischemic disease and vasculitis involving small bowel fall under the category of vascular disorders of the small intestine. Because mesenteric vasculature is primarily affected in these conditions, detection of mesenteric vascular abnormality often is an important step to diagnosis. Traditionally conventional angiography has been the confirmative tool for the detection, diagnosis, and optionally treatment of the vascular disease of the small bowel. However, with the introduction of MDCT which enabled faster scanning and thinner collimation along with detailed 3D reconstruction techniques, CT angiography can nearly perfectly reproduce the images of conventional angiography. Furthermore, CT also allows the evaluation of mural and extraluminal changes of the affected small intestine in various vascular diseases. In this chapter, ischemic small bowel diseases including acute and chronic mesenteric ischemia, which can be occlusive or nonocclusive, radiation enteritis, and vasculitis affecting mesenteric vasculature of variable vessel sizes are covered.