[The role of imaging diagnosis in the study of intestinal infarct]

Acute mesenteric insufficiency is a surgical emergency with a difficult methodological approach. Its high mortality is mainly due to delay in the correct diagnosis. In turn, this is due to the lack of specificity, specially in the early-middle phase, of the clinical presentation, laboratory data, and plain abdominal radiographic findings. In front of this uncertainty, some authors advocated an "aggressive" approach with early use of angiography (nevertheless at risk of a high rate of negative examinations), other remained on more wait-and-see or fatalist positions, and other evaluated the possible diagnostic impact of noninvasive methods alternative to angiography. With the purpose of a correct employment from the surgeon of the various diagnostic tools actually available, we illustrated in this review the possibilities and limitations of the methods proposed in the evaluation of bowel infarction: plain abdominal radiography, gastrointestinal tract contrast studies, angiography, sonography, computed tomography (CT), magnetic resonance imaging (MRI).