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Shock bowel following massive pulmonary embolism
A I De Backer1, A M De Schepper, G Hubens
1Department of Radiology, University Hospital of Antwerp, Edegem, Belgium.
Journal Belge De Radiologie
|December 24, 1997
Summary
Massive pulmonary embolism can cause shock bowel, characterized by reversible small bowel abnormalities due to hypotension. These CT findings differ from acute vascular occlusion.
Area of Science:
- Radiology
- Gastroenterology
- Cardiology
Background:
- Massive pulmonary embolism (PE) can lead to acute hemodynamic collapse and shock.
- Hypotension and hypoperfusion are common complications in patients with severe PE.
- Assessing secondary organ damage is crucial in managing acute cardiovascular events.
Observation:
- CT scans in patients with massive PE and hemodynamic collapse reveal widespread small bowel abnormalities.
- These abnormalities include diffuse small bowel wall thickening, dilation, and fluid accumulation.
- Increased contrast enhancement of the small bowel wall, termed 'shock bowel', is a key observation.
Findings:
- The observed small bowel abnormalities are secondary to prolonged hypoperfusion caused by hypotension.
- These findings represent a reversible state of intestinal injury.
- It is essential to differentiate 'shock bowel' from acute mesenteric ischemia or vascular occlusion.
Implications:
- Recognition of 'shock bowel' on CT is vital for accurate diagnosis in PE patients.
- Understanding the reversibility of these findings can guide clinical management and prognosis.
- This highlights the systemic impact of acute hemodynamic compromise on visceral organs.