Small bowel transmural necrosis secondary to acute mesenteric ischemia and strangulated obstruction: CT findings of 49 patients

Rationale and objectivesTransmural bowel necrosis (TBN) is an uncommon surgical emergency that represents endpoint of occlusive acute mesenteric ischemia (AMI), nonocclusive AMI small obstruction (SBO). According to limited evidence, each etiology TBN might demonstrate a different CT finding. This investigation aimed 1) identify overall findings TBN, 2) compare in etiology.Materials methodsForty-nine consecutive adults (mean age, 64.6 years; 26 men) with AMI, or SBO, pathologically proven were enrolled. All had scan within 24 h before surgery. Clinical information was compiled from medical records. examinations re-reviewed by two radiologists disagreements resolved the third radiologist. Data analyzed compared.ResultsTransmural secondary arterial venous combined SBO 6, 5, 2, 10, patients, respectively. The ascites (93.9%), abnormal wall enhancement (91.8%), dilatation (89.8%), fat stranding thickness (71.5%), pneumatosis (46.9%) intrinsic hyperattenuation walls (22.5%). Portovenous gas, pneumoperitoneum present 4 patients (8.2%). Bowel only showed statistically significant difference among 5 etiologies (P = 0.046).ConclusionsMost common ascites, enhancement, dilatation, stranding. Wall differentiated five etiologies, being most thickened normal AMI.