-To be familiar with representative CT features of the acute mesenteric ischemia.
-To identify the cause of ischemia.
-To learn about the optimal method to detect a potential source of emboli.
Vascular compromise of the gut is responsible for approximately 0.1% of all hospital admissions and 1.0% of admission for an acute abdomen.
Despite advances made in the diagnostic and therapeutic field,
acute intestinal ischemia remains a highly lethal condition.Higher prevalence in the elderly population and nonspecific clinical presentation leading to delayed diagnosis contribute to the high mortality.
Prompt diagnostic and intervention are essential to improve patient survival in this potentially lethal disorder.
Multidetector CT (MDCT) has become the gold standard in evaluating patients with...
Findings and procedure details
MDCT protocols should be optimized for an angiographic study and assessment of the Intestines / mesentery / abdominal viscus:
In this context,
triphasic CT involves the acquisition of scans in the pre-contrast,
arterial and venous phases.
The use of oral contrast is not recommended in patients with AMI.
The transit time for oral contrast through the bowel will delay definitive treatment in AMI and the associated vomiting and adynamic ileus limit the useful passage of oral contrast material.
Intravenous contrast medium:
An uncommon disease,
mesenteric ischemia carries significant morbidity and mortality if not identified early in its course.
Computed tomography has become the initial and best modality to assess for acute mesenteric ischemia because of its ability to evaluate not only the vessels but also the extent of bowel ischemia and/or infarction.
The modality also identifies the cause of mesenteric ischemia and allows for prompt and proper triage and therapy.
Prompt and early diagnosis of mesenteric ischemia requires:
- a high index of suspicion
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Anatomy and physiology of the mesenteric circulation.
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5) Hart J.
Non neoplasic diseases of the small and large intestine.in Sliverberg SG,editor.
Surgical pathology and cytopathology....