- To resume the main features at computed tomography (CT) of acute mesenteric ischemia;
- To provide the key elements for the differential diagnosis among the various etiologies of mesenteric ischemia.
Acute mesenteric ischemia is one of the main life-threatening emergencies a radiologist can face while in an Emergency Department (ED),
with a mortality rate that ranges from 50% to 85% .
Patients often refer to the ED presenting with non-specific symptoms and laboratory tests; a thin-section CT scan,
which still represents the gold standard for diagnosis ,
may be therefore inappropriately delayed.
When acute mesenteric ischemia is suspected,
acquisition of arterial and venous post-contrast phases is recommended ; though useful to distinguish intramural oedema from...
Findings and procedure details
Acute mesenteric ischemia evolves through different stages of severity,
from an early mucosal involvement to a more extensive transmural damage which clearly significantly impacts the patient’s prognosis.
Based on a classification of the American Gastroenterological Association ,
arterial and venous ischemia are usually defined,
with different characteristics at CT scan.
Arterial ischemia is by far the most common etiology.
In most of the cases it is secondary to superior mesenteric artery (SMA) emboli or SMA thrombosis,
usually localized in the proximal third of the vessel...
A deep knowledge of the characteristic CT features of acute mesenteric ischemia in the ED is crucial to support the clinician in rapidly identifying the most appropriate treatment strategy.
Fumoto K et al.
(2018) Acute mesenteric ischemia: multidetector CT findings and endovascular management.
Radiographics 38(3): 945-61
American College of Radiology,
ACR Appropriateness criteria.
Imaging of Mesenteric Ischemia (revised 2018).
Becker BW et al (2009) Evaluation of acute mesenteric ischemia: accuracy of biphasic mesenteric multi-detector CT angiography.
Abdom Imaging 34(3): 345-57
American Gastroenterological Association Medical Position Statement.Guidelines on intestinal isch- emia.