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Congress: ECR25
Poster Number: C-21228
Type: Poster: EPOS Radiologist (educational)
Authorblock: T. A. Leite De Lima, V. Vita Ricci, P. G. C. D. Oliveira, A. S. Ogata, C. Torres, G. De Lion Gouvêa, J. Elias, V. F. Muglia; Ribeirão Preto/BR
Disclosures:
Thalyne Aparecida Leite De Lima: Author: 1
Vitor Vita Ricci: Author: 2
Pamela Grazielle Correa De Oliveira: Author: 3
Arthur Senna Ogata: Author: 4
Cecilia Torres: Author: 5
Gabriel De Lion Gouvêa: Author: 6
Jorge Elias: Author: 7
Valdair Francisco Muglia: Author: 8
Keywords: Abdomen, CT, Contrast agent-intravenous, Education and training
Learning objectives Mesenteric ischemia is a catastrophic event associated with high morbidity and mortality. This review explores the anatomical basis of bowel ischemia, its complex pathophysiology, and the primary imaging findings, with a particular focus on CT images. Recognizing key tomographic patterns is essential for early diagnosis, which can significantly alter the disease's progression.
Read more Background Reduction or interruption of intestinal blood flow, whether due to obstructive or non-obstructive causes, poses a risk of infarction, necrosis, and perforation of the bowel wall.Bowel ischemia accounts for 1-2% of abdominal pain cases in the emergency room and over 10% of acute abdomen cases in the elderly.Imaging is crucial, as early diagnosis is the only way to prevent the life-threatening outcomes of most ischemic events.The preferred diagnostic test is biphasic CT angiography of the upper abdomen and pelvis (arterial...
Read more Findings and procedure details The imaging findings in intestinal ischemia depend on the stage of the condition and the timing of imaging. Figures 11 and 12 [fig 11] , [fig 12] outlines the main imaging findings, highlighting their progression throughout the cascade of events in intestinal ischemia.An important differential diagnosis of mesenteric ischemia is the adynamic ileus, which is illustrate in figure 13 [fig 13] .The thickness and pattern of enhancement of the bowel wall can be a clue to the origin of the ischemia. "Paper-thin" wall suggests arterial...
Read more Conclusion Common imaging findings of acute mesenteric ischemia should be actively sought in the context of acute abdomen in the emergency setting, even in scans with different protocols, especially early signs, as the diagnostic hypothesis is not always considered by the requesting physician.
Read more References Olson MC, Bach CR, Wells ML, Andrews JC, KhandelwalA, WelleCL, FidlerJL. Imaging of BowelIschemia: An Update, From theAJRSpecial Series on Emergency Radiology. AJR Am J Roentgenol.2023 Feb;220(2):173-185. doi: 10.2214/AJR.22.28140. Epub2022 Aug 10. PMID: 35946859.CiaccioB, CaponiA, AntoniniC, CappettiP. Ischemia intestinaleacuta.Revisionedellaletteraturaedesperienzapersonale[Acute intestinal ischemia. Review of theliterature and personal experience]. Minerva Cardioangiol. 1997 Jan-Feb;45(1-2):43-7. Italian.PMID: 9213815.HøyerC, Christensen MH, SandermannJ, LeusinkR, Abrahamsen J. Chronic mesenteric ischaemia:the importance of the individual mesenteric artery. ClinPhysiolFunctImaging. 2022Jan;42(1):15-22. doi: 10.1111/cpf.12730. Epub2021 Oct 12. PMID: 34608740.BombergH, StroederJ, KarrenbauerK, GroesdonkHV,...
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