Intestinal ischemia in patients in whom small bowel obstruction is suspected: evaluation of accuracy, limitations, and clinical implications of CT in diagnosis.

Balthazar, EJ; Liebeskind, Marc E; Macari, Michael

doi:10.1148/radiology.205.2.9356638

Cited by 157 publications

(100 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Subtle pathological changes that occur during reversible ischemia phase are clinically silent, but may be revealed by radiological investigations. CT signs indicative of strangulation pertain to abnormalities in the small-bowel wall and charac- (17) reported higher specificity of 93% that was accompanied with a sensitivity of 83% for strangulation. This variation in CT diagnostic performance may be due to subtle findings that are often only suspected and can be interpreted differently by various investigators (17).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The role of D-dimer in the diagnosis of strangulated small-bowel obstruction

Boguševičius¹,

Grinkevičius²,

Maleckas³

et al. 2007

Medicina

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…Ultrasonography (US) and computer tomography (CT) are promising tools, but their definitive role in the diagnosis of strangulated obstruction has still to be established (16)(17)(18)(19). Some biochemical markers have been used for the diagnosis of mesenteric ischemia (20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

The role of D-dimer in the diagnosis of strangulated small-bowel obstruction

Boguševičius¹,

Grinkevičius²,

Maleckas³

et al. 2007

Medicina

View full text Add to dashboard Cite

show abstract

“…Nevertheless, one of the more common reasons for small bowel ischemia encountered in our daily routine is complicated small bowel obstruction including closed loop obstruction with strangulation by adhesions, incarceration in internal or external hernias or small bowel volvulus in which the involved small bowel may show venous or hemorrhagic ischemia and/or infarction that is caused by mechanically induced extrinsic occlusion of the mesenteric veins with or without subsequent mesenteric venous thrombosis (22)(23).…”

Section: Resultsmentioning

confidence: 99%

“…It is known, that in context with clinical and radiological findings of acute small bowel obstruction the presence of small bowel wall thickening, ascites and mesenteric stranding at CT has a high sensitivity and specificity for the diagnosis of strangulation induced venous small bowel ischemia (22)(23)(24).…”

mentioning

confidence: 99%

Small bowel ischemia caused by strangulation in complicated small bowel obstruction. ct findings in 20 cases with histo - pathological correlation

Wiesner¹,

Mortelé²

2011

Journal of the Belgian Society of Radiology

View full text Add to dashboard Cite

Acute bowel ischemia is a complex entity that may affect both the large and the small bowel and that can result from a variety of different conditions that critically disturb intestinal perfusion (1, 2). The clinical, radiological and histopathological presentation of bowel ischemia may show a wide range. In partial mural bowel ischemia the ischemic damage of the intestine may be limited to the mucosa, or it may be more pronounced and affect also the submucosal space or the muscularis propria. Contrarily, in transmural bowel ischemia (ie. bowel infarction) the ischemic bowel wall damage involves all layers and typically represents a full thickness necrosis of the affected bowel wall.While mild ischemic bowel lesions involving only the mucosa are typically self limiting and reversible, more pronounced ischemic bowel wall damage involving also the submucosal space or the muscularis propria may lead to scarring and strictures as a late complication. Therefore, surgical bowel resection is not absolutely necessary (suggesting thromboembolic disease), or just a typical and suggestive clinical setting such as a positive medical history of prior abdominal aortic surgery, retrograde angiography, atrial fibrillation, cardiovascular disease, hypotensive episodes, hematological disorders, vasculitis or known administration of certain drugs (10-21).However, the majority of histopathologically proven cases of small bowel ischemia in our daily routine represent venous ischemia, caused by extrinsic compression of mesenteric veins in patients with complicated small bowel obstruction, in which the presence of bowel ischemia usually represents only an additional, but surely important finding, since it strongly influences the further management of these patients. It is known, that in context with clinical and radiological findings of acute small bowel obstruction the presence of small bowel wall thickening, ascites and mesenteric stranding at CT has a high sensitivity and specificity for the diagnosis of strangulation induced venous small bowel ischemia (22)(23)(24).However, differentiation between partial mural and transmural bowel ischemia is difficult by CT as long as perforation has not yet occurred and as long as pronounced pneumatosis or portal venous gas do not indicate a more severe and potentially in mild and only partial mural bowel ischemia, whereas transmural bowel infarction definitely requires surgical resection of the necrotic bowel segments.Over the past years CT has become the key imaging modality for the detection of acute bowel ischemia. It is well known that bowel ischemia may present with a wide range of imaging findings at CT including bowel wall thickening, absent or heterogeneous bowel wall enhancement, hypo-or hyperattenuating bowel wall thickening, mesenteric fluid and ascites, pneumatosis or even mesenteric or portal venous gas (2-9). Although many of these CT findings are not highly specific, the diagnosis of intestinal ischemia can be made with a high accuracy by CT if there are additional radiological ...

show abstract

“…[1,12] The diagnosis of small bowel ischemia in the presence of obstruction is more challenging, with sensitivities ranging from 75% to 100% and specificities from 61% to 93%. [20,21] Decreased enhancement of the bowel wall after administration of intravenous contrast is the most specific sign of ischemic bowel. The other useful finding is the "small bowel feces sign" which is defined as gas and solid material within a distended small bowel loop that simulates the appearance of feces.…”

Section: A B C D World J Emerg Med Vol 3 No 3 2012 Pothiawala Et Almentioning

confidence: 99%

Early diagnosis of bowel obstruction and strangulation by computed tomography in emergency department

Pothiawala¹,

Gogna²

2012

World Journal of Emergency Medicine

View full text Add to dashboard Cite

Intestinal ischemia in patients in whom small bowel obstruction is suspected: evaluation of accuracy, limitations, and clinical implications of CT in diagnosis.

Cited by 157 publications

References 0 publications

The role of D-dimer in the diagnosis of strangulated small-bowel obstruction

The role of D-dimer in the diagnosis of strangulated small-bowel obstruction

Small bowel ischemia caused by strangulation in complicated small bowel obstruction. ct findings in 20 cases with histo - pathological correlation

Early diagnosis of bowel obstruction and strangulation by computed tomography in emergency department

Contact Info

Product

Resources

About