Acute SMA embolus resulting in long segments of jejunal ischemia and infarction. The suspected cause was the narrowing at the SMA origin which was felt to be a probable dissection which caused the distal emboli. It is unclear why this occurred, as it could be spontaneous or related to segmental medial arteriolysis.
Notice the downstream small bowel loops (jejunum) which characteristic findings of arterial ischemia with reperfusion injury. Specifically, there is abrupt cutoff from enhancing bowel to nonenhancing bowel typical of embolic ischemia to the distal branches, and also thickening, which occurs after some reperfusion is restored and there is injury to the bowel wall. This patient underwent resection of small bowel and embolectomy with a complex post-operative course.