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 years
Gender: Male

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

CT

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.

  • Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

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