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Localized small bowel ischemia - ileum (CT angiography)

Case contributed by Chris O'Donnell
Diagnosis almost certain

Presentation

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

Patient Data

Age: 65 years
Gender: Male

Preliminary NCCT followed

ct

Preliminary NCCT 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 likely 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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