Type:
Educational Exhibit
Keywords:
Ischaemia / Infarction, Diagnostic procedure, CT, Vascular, Emergency, Abdomen
Authors:
A. Dallorto1, M. Galluzzo2, M. Trinci2, R. Ferrari2, G. Calabrese3; 1Udine/IT, 2Rome/IT, 3roma/IT
DOI:
10.26044/ecr2019/C-3266
Background
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% [1].
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 [2],
may be therefore inappropriately delayed.
When acute mesenteric ischemia is suspected,
acquisition of arterial and venous post-contrast phases is recommended [2]; though useful to distinguish intramural oedema from haemorrhage,
the necessity of unenhanced scan is still under debate [3].
CT findings of all the various etiologies of acute mesenteric ischemia have been well described in several papers.
Nevertheless it is fundamental for the radiologist not only to recognize the key elements that could lead to the correct diagnosis,
but also to keep in mind that some of the most common features may be absent,
especially in the early phases of disease,
even in cases that could benefit from a prompt surgical approach.