Case contributed by Henry Knipe
Diagnosis probable


Sudden onset abdominal pain, hypotension and vomiting. Mildly tender abdomen on examination.

Patient Data

Age: 50 years
Gender: Male

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.

Case Discussion

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. 

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