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CT manifestations of small bowel ischemia due to impaired venous drainage-with a correlation of pathologic findings

View Article: PubMed Central - PubMed

ABSTRACT

Acute abdominal pain may result from a wide variety of medical and surgical diseases. One of these diseases is small bowel ischemia, which may result in a catastrophic outcome if not recognized and treated promptly. Computed tomography (CT) by its faster image acquisition, thinner collimation, high resolution, and multiplanar reformatted images has become the most important imaging modality in evaluating the acute abdominal conditions. In this article, the author presents a description of the histology of the small bowel, pathophysiology of small bowel change, and a correlation of the pathologic and CT findings of the small bowel injuries due to impaired venous drainage. A convincing correlation of the microscopic mucosal condition with the enhancement pattern of the thickened small bowel wall on CT is useful in definitely describing the mucosal viability.

No MeSH data available.


Related in: MedlinePlus

A 58-year-old woman with mesenteric panniculitis, which is a preceding process of retractile mesenteritis. Varying degrees of mesenteric fibrosis may constrict venous branches and result in impaired venous drainage. (A) Non-enhanced scan. The small bowel wall (SB) is symmetrically thickened and hypoattenuating relative to the muscles (arrowheads). The mesenteric fat (M) is diffusely hyperattenuated to the other fatty tissues and partly covered anteriorly by the thickened visceral peritoneum (arrow) of the mesentery. (B) On this contrast-enhanced scan, the congested wall has become hyperdense to the muscles
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Figure 3: A 58-year-old woman with mesenteric panniculitis, which is a preceding process of retractile mesenteritis. Varying degrees of mesenteric fibrosis may constrict venous branches and result in impaired venous drainage. (A) Non-enhanced scan. The small bowel wall (SB) is symmetrically thickened and hypoattenuating relative to the muscles (arrowheads). The mesenteric fat (M) is diffusely hyperattenuated to the other fatty tissues and partly covered anteriorly by the thickened visceral peritoneum (arrow) of the mesentery. (B) On this contrast-enhanced scan, the congested wall has become hyperdense to the muscles

Mentions: The submucosa may only show mild enhancement because its capillary network is much less than that of the mucosa. The density of the edematous or hemorrhagic submucosa is lower than that of the adjacent abdominal wall or psoas muscles [Figure 2D] on the contrast-enhanced scans, as the muscles enhance normally. A chronically congested or hyperemic wall has low attenuation compared with that of the muscles before intravenous contrast enhancement. It shows strong, whole-thickness enhancement, and becomes isodense or hyperdense to the muscles on the post-contrast scan [Figure 3].


CT manifestations of small bowel ischemia due to impaired venous drainage-with a correlation of pathologic findings
A 58-year-old woman with mesenteric panniculitis, which is a preceding process of retractile mesenteritis. Varying degrees of mesenteric fibrosis may constrict venous branches and result in impaired venous drainage. (A) Non-enhanced scan. The small bowel wall (SB) is symmetrically thickened and hypoattenuating relative to the muscles (arrowheads). The mesenteric fat (M) is diffusely hyperattenuated to the other fatty tissues and partly covered anteriorly by the thickened visceral peritoneum (arrow) of the mesentery. (B) On this contrast-enhanced scan, the congested wall has become hyperdense to the muscles
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036332&req=5

Figure 3: A 58-year-old woman with mesenteric panniculitis, which is a preceding process of retractile mesenteritis. Varying degrees of mesenteric fibrosis may constrict venous branches and result in impaired venous drainage. (A) Non-enhanced scan. The small bowel wall (SB) is symmetrically thickened and hypoattenuating relative to the muscles (arrowheads). The mesenteric fat (M) is diffusely hyperattenuated to the other fatty tissues and partly covered anteriorly by the thickened visceral peritoneum (arrow) of the mesentery. (B) On this contrast-enhanced scan, the congested wall has become hyperdense to the muscles
Mentions: The submucosa may only show mild enhancement because its capillary network is much less than that of the mucosa. The density of the edematous or hemorrhagic submucosa is lower than that of the adjacent abdominal wall or psoas muscles [Figure 2D] on the contrast-enhanced scans, as the muscles enhance normally. A chronically congested or hyperemic wall has low attenuation compared with that of the muscles before intravenous contrast enhancement. It shows strong, whole-thickness enhancement, and becomes isodense or hyperdense to the muscles on the post-contrast scan [Figure 3].

View Article: PubMed Central - PubMed

ABSTRACT

Acute abdominal pain may result from a wide variety of medical and surgical diseases. One of these diseases is small bowel ischemia, which may result in a catastrophic outcome if not recognized and treated promptly. Computed tomography (CT) by its faster image acquisition, thinner collimation, high resolution, and multiplanar reformatted images has become the most important imaging modality in evaluating the acute abdominal conditions. In this article, the author presents a description of the histology of the small bowel, pathophysiology of small bowel change, and a correlation of the pathologic and CT findings of the small bowel injuries due to impaired venous drainage. A convincing correlation of the microscopic mucosal condition with the enhancement pattern of the thickened small bowel wall on CT is useful in definitely describing the mucosal viability.

No MeSH data available.


Related in: MedlinePlus