Skip to main content

Errors in the MDCT Diagnosis of Intestinal Ischemia and Infarction

  • Chapter
  • 1933 Accesses

Abstract

The diagnosis of vascular intestinal disorders continues to pose a crucial challenge in the evaluation of computed tomography (CT) scans in patients with acute abdominal syndrome. The ability to distinguish between and correctly interpret the related findings of ischemia (a potentially reversible event) and infarction (a non-reversible event, with inevitable death of the involved bowel segment) is the first step in a correct diagnostic workup and image analysis. In fact, ischemia and infarction indicate different stages of an injury caused by interruption of the blood supply to the tissue [1, 2]. Three main conditions underlie an intestinal ischemic event: (1) a deficiency in the arterial blood supply, mainly related to embolism or thrombosis (splanchnic); (2) impaired venous drainage (post-splanchnic); (3) decreased mesenteric blood flow (the “low-flow” state) due, for example, to cardiac failure, myocardial infarction, bleeding, hypovolemia (pre-splanchnic) [24].

Keywords

  • Bowel Wall
  • Compute Tomography Finding
  • Intestinal Ischemia
  • Ischemic Disease
  • Mesenteric Venous Thrombosis

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-88-470-2339-0_15
  • Chapter length: 8 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   109.00
Price excludes VAT (USA)
  • ISBN: 978-88-470-2339-0
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   139.99
Price excludes VAT (USA)
Fig. 15.1
Fig. 15.2
Fig. 15.3
Fig. 15.4
Fig. 15.5
Fig. 15.6
Fig. 15.7

References

  1. Fenoglio-Preiser C.M, Noffsinger AE, Stemmermann GN et al (2008) The nonneoplastic Small Intestine. In: Fenoglio-Preiser CM, Noffsinger AE, Stemmermann GN et al (eds) Gastrointestinal pathology. An atlas and text, 3rd edn. Wolters Kluwer — Lippincott Williams & Wilkins, Philadelphia, PA USA, pp 326–339

    Google Scholar 

  2. Romano S, Romano L (2011) Acute mesenteric ischemia and ischemic colitis. In: Taourel P (ed) CT of the acute abdomen. Medical radiology. Diagnostic imaging. Springer-Verlag, Berlin Heidelberg, pp 183–197

    Google Scholar 

  3. Paterno F, Longo WE (2008) The etiology and pathogenesis of vascular disorders of the intestine. Radiol Clin North Am 46: 877–885

    PubMed  CrossRef  Google Scholar 

  4. Klatte EC, Becker GJ, Yune HY et al (1982) Angiographic studies of the upper gastrointestinal tract. In: Scott HW, Sawyers JL (eds) Surgery of the stomach, duodenum and small intestine. Blackwell Scientific, Cambridge MA, USA, pp 194–197

    Google Scholar 

  5. Gore RM, Yaghmai V, Thakar KH et al (2008) Imaging in intestinal ischemic disorders. Radiol Clin North Am 46: 845–875

    PubMed  CrossRef  Google Scholar 

  6. Romano S, Niola R, Maglione F et al (2008) Small bowel vascular disorders from arterial etiology and impaired venous drainage. Radiol Clin North Am 46: 891–908

    PubMed  CrossRef  Google Scholar 

  7. Romano S, Lassandro F, Scaglione M et al (2006) Ischemia and infarction of the small bowel and colon: spectrum of imaging findings. Abdom Imag 31: 277–292

    CrossRef  CAS  Google Scholar 

  8. Chou CK, Mak CW, Tzeng WS et al (2004) CT of small bowel ischemia. Abdom Imaging 29:18–22

    PubMed  CrossRef  CAS  Google Scholar 

  9. Noer RJ (1943) The blood vessels of the jejunum and ileum: a comparative study of man and certain laboratory animals. Am J Anat 73: 293–334

    CrossRef  Google Scholar 

  10. Polk HC Jr (1966) Experimental mesenteric venous occlusion III. Diagnosis and treatment of induced mesenteric venous thrombosis. Ann Surg 163:432–444

    PubMed  CrossRef  Google Scholar 

  11. Laureano BA, Wade TP (1998). Mesenteric venous disease. In: Longo WE, Peterson GJ, Jacobs DL (eds) Intestinal ischemia disorders. Quality Medical, St. Louis MO, USA, pp 207–219

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2012 Springer-Verlag Italia

About this chapter

Cite this chapter

Romano, S., Ponticiello, G., Russo, G. (2012). Errors in the MDCT Diagnosis of Intestinal Ischemia and Infarction. In: Romano, L., Pinto, A. (eds) Errors in Radiology. Springer, Milano. https://doi.org/10.1007/978-88-470-2339-0_15

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2339-0_15

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2338-3

  • Online ISBN: 978-88-470-2339-0

  • eBook Packages: MedicineMedicine (R0)