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Congress: ECR24
Poster Number: C-16741
Type: EPOS Radiologist (educational)
DOI: 10.26044/ecr2024/C-16741
Authorblock: A-E. Fota, T. Matei, R. M. Manea; Brasov/RO
Disclosures:
Adelina-Elena Fota: Nothing to disclose
Teodora Matei: Nothing to disclose
Rosana Mihaela Manea: Nothing to disclose
Keywords: Abdomen, Gastrointestinal tract, Vascular, CT, CT-Angiography, CT-High Resolution, Arterial access, Complications, Contrast agent-intravenous, Acute, Embolism / Thrombosis, Ischaemia / Infarction
Findings and procedure details

In this study were included 31 patients, 15 females and 16 males. The range of ages was between 39 and 89 years old (with a mean age of 72). Abdominal pain, vomiting and diarrhea were the most prevalent signs during admission. The most common CT changes at the level of small bowels were: distension (48.4%), hydroaeric levels (54.8%) and pneumatosis intestinalis (25.8%).  In sixteen patients  (51.6%) a vascular cause (calcareous atheroma/thrombosis) was demonstrated by abdominal contrast-enhanced CT. Ascite was a nonspecific symptom that affected 41.9% of patients.

Surgery was performed on all patients and 10 of them (32.2%) had successful outcomes with full recovery. In these cases, there was a intrasurgical evidence of segmental mesenteric ischemia and subtotal enterectomy with entero-enteral anastomosis was performed.  Among the patients who survived, five presented CT changes at the level of mesenteric vessels. In 70% of these cases, there were hydroaeric intestinal levels on the abdominal CT  and ascites fluid was present in 60% of these patients. Only two of the patients who experienced a positive course of events, developed intestinal pneumatosis and none of them had air in the mesenteric or portal venous system. This two changes indicate transmural infarction of the bowel, and may or may not be associated with perforation, which lead to a poor prognosis.

GALLERY