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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

Same patient as in Figure 13. Kerckring folds (arrows) of the longitudinally sectioned, distended bowel isapproximately 4–6 mm high and 2–3 mm thick, with a 2–3 mm interfold distance. The section thickness is 7.5mm. A transverse scan of the wall (rectangles) would involve two folds at most like that of the adjacent, continuous, transversely sectioned bowel (arrowheads); this can mimic a target sign or a poorly enhancing thickened wall. This appearance should not be interpreted as wall thickening
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Figure 14: Same patient as in Figure 13. Kerckring folds (arrows) of the longitudinally sectioned, distended bowel isapproximately 4–6 mm high and 2–3 mm thick, with a 2–3 mm interfold distance. The section thickness is 7.5mm. A transverse scan of the wall (rectangles) would involve two folds at most like that of the adjacent, continuous, transversely sectioned bowel (arrowheads); this can mimic a target sign or a poorly enhancing thickened wall. This appearance should not be interpreted as wall thickening

Mentions: The second condition occurs with cross-sectional imaging of a distended jejunum filled with low-attenuating fluid [Figure 14]. Because of a partial volume-averaging effect, normal folds may look like a poorly enhancing or target-like thickened wall. To avoid this mistake, it is better to measure the wall thickness on a longitudinal section of the small bowel.[11]


CT manifestations of small bowel ischemia due to impaired venous drainage-with a correlation of pathologic findings
Same patient as in Figure 13. Kerckring folds (arrows) of the longitudinally sectioned, distended bowel isapproximately 4–6 mm high and 2–3 mm thick, with a 2–3 mm interfold distance. The section thickness is 7.5mm. A transverse scan of the wall (rectangles) would involve two folds at most like that of the adjacent, continuous, transversely sectioned bowel (arrowheads); this can mimic a target sign or a poorly enhancing thickened wall. This appearance should not be interpreted as wall thickening
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 14: Same patient as in Figure 13. Kerckring folds (arrows) of the longitudinally sectioned, distended bowel isapproximately 4–6 mm high and 2–3 mm thick, with a 2–3 mm interfold distance. The section thickness is 7.5mm. A transverse scan of the wall (rectangles) would involve two folds at most like that of the adjacent, continuous, transversely sectioned bowel (arrowheads); this can mimic a target sign or a poorly enhancing thickened wall. This appearance should not be interpreted as wall thickening
Mentions: The second condition occurs with cross-sectional imaging of a distended jejunum filled with low-attenuating fluid [Figure 14]. Because of a partial volume-averaging effect, normal folds may look like a poorly enhancing or target-like thickened wall. To avoid this mistake, it is better to measure the wall thickness on a longitudinal section of the small bowel.[11]

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