Ischaemic gut

Case contributed by Dr Henry Knipe

Presentation

RUQ and right flank pain.

Patient Data

Age: 80
Gender: Female
CT

Thickwalled loops of ileum that are hypoenhancing. The caecum and ascending colon to the level of the hepatic flexure is also mildly thickwalled and hypoenhancing. Associated mild mesenteric fat stranding.

Filling defect within the mid SMA, just distal to the origin of the jejunal branches. There is also filling defect within the superior mesenteric vein. Portal vein is patent. No portal venous gas and no areas of mural gas within the affected small and large bowel.

Liver has a slightly mottled appearance. Wedge-shaped peripheral hypodensity within the spleen may be an infarct.

Case Discussion

Ischaemic gut, especially in the elderly, has a very poor prognosis with a high mortality. Common causes include SMA thrombus or embolus (e.g. from AF). 

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Case information

rID: 39558
Case created: 9th Sep 2015
Last edited: 14th Nov 2015
Inclusion in quiz mode: Included

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