[Acute mesenteric ischemia: Value of cross-sectional imaging]

E Delhom1, S Aufort, V Shrembi

  • 1Service d'imagerie médicale, CHU Saint-Eloi, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France. e-delhom@chu-montpellier.fr

Journal De Radiologie
|December 14, 2011
PubMed

Insights

Acute mesenteric ischemia (AMI) requires prompt diagnosis. CT scans are crucial for identifying AMI, showing specific imaging features like bowel wall changes and gas within vessels.

Area of Science:

  • Radiology
  • Gastroenterology
  • Emergency Medicine

Background:

  • Acute mesenteric ischemia (AMI) is a critical surgical emergency.
  • Delayed diagnosis and treatment significantly worsen patient prognosis.
  • Clinical and laboratory findings for AMI are often nonspecific.

Purpose of the Study:

  • To highlight the importance of imaging in diagnosing AMI.
  • To differentiate between arterial and venous mesenteric ischemia.
  • To outline key CT and ultrasound findings indicative of AMI.

Main Methods:

  • Review of CT and ultrasound imaging features in patients with acute abdomen.
  • Emphasis on CT as a first-line modality due to high sensitivity (90%).
  • Discussion of distinct imaging characteristics for arterial vs. venous ischemia.

Main Results:

  • CT and ultrasound reveal specific signs of AMI.
  • Key findings include bowel wall thickening/enhancement abnormalities, pneumatosis, and portal venous gas.
  • Intravascular thrombus, bowel dilatation, and ascites are also significant indicators.

Conclusions:

  • Imaging, particularly CT, is imperative for timely AMI diagnosis.
  • Recognizing specific imaging features aids in differentiating arterial and venous ischemia.
  • Prompt identification through imaging improves patient outcomes for acute mesenteric ischemia.

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