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Localised ischaemic small bowel (ileum) - CT angiography

Case contributed by: Dr Chris O'Donnell

Presentation:

2 days of severe abdominal pain, vomitting. Virgin abdomen.

Patient Data:

Age: 65

Gender: Male

From the case: Localised ischaemic small bowel (ileum) - CT angiography

Modality: CT

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C+ arterial phase

Preliminary non contrast CT followed by CT mesenteric angiogram and portal venous phase.

Distended fluid filled jejunum with normal enhancing walls especially on the arterial phase. Collapsed terminal ileum with normal enhancing walls. Distended, thick-walled ileum with no enhancement of the walls on either the arterial or portal venous phases = ischaemic bowel most likley due to a closed loop (probably an internal hernia given the absence of previous surgical history to indicate adhesions). Findings confirmed at laparotomy.