Localized ischemic small bowel (ileum): CT angiography

Case contributed by Dr Chris O'Donnell

Presentation

2 days of severe abdominal pain, vomitting. Virgin abdomen.

Patient Data

Age: 65
Gender: Male

Preliminary non contrast CT followed by CT mesenteric angiogram and portal venous phase.

Distended fluid filled jejunum with normal enhancing walls especially on the arterial phase. Collapsed terminal ileum with normal enhancing walls.  Distended, thick-walled ileum with no enhancement of the walls on either the arterial or portal venous phases = ischemic bowel most likley due to a closed loop (probably an internal hernia given the absence of previous surgical history to indicate adhesions).  Findings confirmed at laparotomy.

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Case information

rID: 17601
Published: 28th Apr 2012
Last edited: 13th Aug 2019
Inclusion in quiz mode: Included

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