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Updated: Aug 18, 2025

Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Understanding CT imaging findings based on the underlying pathophysiology in patients with small bowel ischemia
Yuko Nakamura1, Shota Kondo2, Keigo Narita2
1Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan. yukon@hiroshima-u.ac.jp.
Abstract:
Because acute small bowel ischemia has a high mortality rate, it requires rapid intervention to avoid unfavorable outcomes. Computed tomography (CT) examination is important for the diagnosis of bowel ischemia. Acute small bowel ischemia can be the result of small bowel obstruction or mesenteric ischemia, including mesenteric arterial occlusion, mesenteric venous thrombosis, and non-occlusive mesenteric ischemia. The clinical significance of each CT finding is unique and depends on the underlying pathophysiology. This review describes the definition and mechanism(s) of bowel ischemia, reviews CT findings suggesting bowel ischemia, details factors involved in the development of small bowel ischemia, and presents CT findings with respect to the different factors based on the underlying pathophysiology. Such knowledge is needed for accurate treatment decisions.
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