CT hypotension complex

Case contributed by Hisham Alwakkaa
Diagnosis certain


History of severe poly-trauma following motor vehicle accident.

Patient Data

Age: 5 years
Gender: Female

Lung bases:  multifocal small airspace opacities in the right lung base.

Bowel: there is mild diffuse wall thickening with diffuse marked enhancement involving the small bowel and the proximal large bowel (cecum, ascending and transverse colon). No appreciable wall injury.

Retroperitoneal space: diffuse fluid attenuation is noted in the retroperitoneal space including the pancreatic bed and around the IVC. No appreciable pancreatic parenchymal injury. Diameters of the IVC and aorta are preserved.

Liver: there are circumferential areas of decreased attenuation surrounding the portal venous branches throughout the liver. No evidence of hepatic parenchymal injury.

No additional significant pathology noted.

Case Discussion

This case illustrates two features of the CT hypotension complex:

  • mild, diffuse wall thickening with marked and diffuse wall enhancement involving most of the bowel (known previously as shock bowel)
  • fluid attenuation around the pancreas and the IVC

Also, the periportal halo sign is clearly demonstrated on the study; likely secondary to aggressive fluid resuscitation.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.