Sudden onset abdominal pain, hypotension and vomiting. Mildly tender abdomen on examination.
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Multiple loops of contiguous small bowel (jejunum) are thick walled with associated mesenteric fat stranding. Terminal ileum appears normal. Small volume of free fluid, mainly perihepatic. No free gas. SMA/SMV are patent. No portal vein thrombosis. Colon is unremarkable. Normal appendix.
Findings reflect enteritis and the underlying cause is often not identified on CT. The differential is broad including infection, inflammatory (e.g. Crohn disease), or vascular (i.e. ischemia). No evidence of arterial and venous thrombus, and clinically it was thought to be a viral enteritis.