Ischaemic small bowel

Case contributed by Dr Ian Bickle

Presentation

1-day history of generalised mild abdominal pain. Mild abdominal distension. Diverticulitis?

Patient Data

Age: 75 years
Gender: Female
CT

Long segment of markedly thickened non-enhancing proximal ileum low in the pelvis with surrounding perienteric inflammatory change.

Thrombus in the SMV from its origin and the infrarenal IVC.

Inflammatory change in the small bowel mesentery. 

Small volume intraperitoneal free fluid. No free abdominal gas.

Photo

Emergency laparotomy performed.

A 20 cm segment of ischaemic proximal ileum found at surgery.

Resection and anastomosis were performed.

Case Discussion

An excellent example of ischaemic bowel with surgical confirmation.

The wall is thickened and devoid of enhancement.

In this case the thrombus is also evident in the SMV.

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Case information

rID: 52750
Case created: 20th Apr 2017
Last edited: 9th Jun 2017
Inclusion in quiz mode: Included

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