Objectives

To review the anatomy and pathophysiology of acute mesenteric ischemia.

To describe and illustrate the main and ancillary radiological findings on multidetector computed tomography (MCDT).

Background

Acute mesenteric ischemia (AMI) is a condition caused by insufficient blood flow to the bowel, resulting in ischemia and eventual necrosis of the bowel wall. It is a rare event but also a life-threatening condition, usually requiring emergent intervention or surgery.

The causes of AMI include arterial embolic or thrombotic obstruction, mesenteric venous thrombosis or a non-occlusive etiology. The most common cause is arterial occlusion.

Imaging findings OR Procedure findings

The absence of specific clinical signs and symptoms makes early detection of this condition difficult, therefore the image is crucial for the diagnosis. Contrast material–enhanced MDCT is the first-line imaging method for early diagnosis of AMI and for differentiation from other causes of acute abdomen.

Accurate diagnosis depends on understanding the vascular anatomy and pathophysiology of various types of mesenteric ischemia and their corresponding imaging findings on MDCT.

MDCT findings vary widely, depending on the underlying cause and the presence of associated complications. At MDCT scan, not only it’s important to examine the bowel wall, but also assess the mesenteric vasculature, mesenteric fat and surrounding peritoneal cavity, in order to improve the diagnosis.

Conclusion

The recognition of the radiological findings of mesenteric ischemia on MDTC and the different variations depending on the cause are essential for an accurate diagnosis in the correct clinical setting.

Objectives

To review the anatomy and pathophysiology of acute mesenteric ischemia.

To describe and illustrate the main and ancillary radiological findings on multidetector computed tomography (MCDT).

Background

Acute mesenteric ischemia (AMI) is a condition caused by insufficient blood flow to the bowel, resulting in ischemia and eventual necrosis of the bowel wall. It is a rare event but also a life-threatening condition, usually requiring emergent intervention or surgery.

The causes of AMI include arterial embolic or thrombotic obstruction, mesenteric venous thrombosis or a non-occlusive etiology. The most common cause is arterial occlusion.

Imaging findings OR Procedure findings

The absence of specific clinical signs and symptoms makes early detection of this condition difficult, therefore the image is crucial for the diagnosis. Contrast material–enhanced MDCT is the first-line imaging method for early diagnosis of AMI and for differentiation from other causes of acute abdomen.

Accurate diagnosis depends on understanding the vascular anatomy and pathophysiology of various types of mesenteric ischemia and their corresponding imaging findings on MDCT.

MDCT findings vary widely, depending on the underlying cause and the presence of associated complications. At MDCT scan, not only it’s important to examine the bowel wall, but also assess the mesenteric vasculature, mesenteric fat and surrounding peritoneal cavity, in order to improve the diagnosis.

Conclusion

The recognition of the radiological findings of mesenteric ischemia on MDTC and the different variations depending on the cause are essential for an accurate diagnosis in the correct clinical setting.