Table I. Major Clinical and CT Findings of Bowel Ischemia.
Features | Arterial Ischemia |
Venous Ischemia |
Non-occlusive Ischemia |
---|---|---|---|
Incidence | 60-70% | 5-10% | 20-30% |
Acuity | Acute or chronic | Acute or chronic | Acute or chronic |
Clinical Risk
Factors |
Cardiovascular disease: Atrial fibrillation, post- Myocardial infarction, aortic injury, atherosclerosis. septic emboli. systemic vasculitis. |
Bowel strangulation, hypercoagulable state, portal hypertension, venous trauma, infection |
Hypotension, heart failure, recent surgery or trauma, medications including recreational |
Vasculature | Arterial filling defect, severe arterial narrowing, dissection, aneurysm |
Venous filling defect, often with enlarged venous diameter |
Non-specific |
Bowel Wall
Thickness |
May be thin acutely, but may be thickened and involved with hematoma, edema, or inflammation |
Thickened and edematous |
Generally thickened |
Bowel Wall
Enhancement |
Variable; diminished or non- enhancement in regions of pale ischemia; hyperenhancement in areas of reperfusion |
Diminished enhancement of mucosa and serosa, target appearance |
Diminished enhancement |
Mesentery/Fat | Mesenteric fat stranding with free fluid associated with the territory of ischemia |
Mesenteric fat stranding with free fluid associated with the territory of ischemia |
Mesenteric fat stranding with free fluid associated with the territory of ischemia |