Imaging in Intestinal Ischemic Disorders

Management of Acute and Chronic Mesenteric Ischemia

“…Embolism to the visceral vessels is the most common etiology of acute mesenteric ischemia, accounting for approximately 30 -50% of cases (18,23,24) . Acute mesenteric ischemia develops over the course of minutes to hours and results from a sudden occlusion of a major abruptly as it does in acute mesenteric occlusion secondary to embolus (26,28) .…”

“…CT angiography may demonstrate SMA embolism. Duplex ultrasonography may reveal bowel -wall thickening, extraluminal fl uid, absent peristalsis, or vessel thrombosis (24) . Duplex ultrasonography is helpful in diagnosis of mesenteric stenosis, although the sensitivity is dependent on patient and technologist factors (23) .…”

Primary percutaneous aspiration and thrombolysis for the treatment of acute embolic superior mesenteric artery occlusion

“…Before revascularization the potential of ischemic bowel to regenerate cannot be confidently predicted [2]. Hence, quick mesenteric revascularization is of utmost importance in order to prevent further bowel infarction, facilitate regeneration of ischemic but potentially viable bowel, and promote proper healing of bowel anastomosis [2,3,5,[7][8][9]. After revascularization infarcted bowel segments are resected [2,4,7].…”

“…The key to salvaging ischemic bowel and saving patient life is early diagnosis and rapid revascularization before bowel ischemia progresses to irreversible bowel infarction [2][3][4][5][6]. Before revascularization the potential of ischemic bowel to regenerate cannot be confidently predicted [2].…”

Limited utility of MRA for acute bowel ischemia after portal venous phase CT

“…In an epidemiologic study of Malmo¨, Sweden, an estimate of incidence rate was given as 12.9 per 100,000 years [1], or 1 in 1000 acute hospital admissions [2] with estimated mortality rates of 60-80% [3]. AMI entails vascular compromise of the small bowel and encompasses a variety of etiologies, including mesenteric arterial embolic or thrombotic occlusion, mesenteric venous thrombosis, and nonocclusive mesenteric ischemia [4]. Acute arterial thromboembolism accounts for nearly two-third of cases [5], compared with smaller proportions for venous thrombosis (10%) and nonocclusive ischemia (25%) [6].…”