Mesenteric infarct

Case contributed by Marius I. Diaconescu


Patient with abdominal pain, particularly at the right lower quadrant, please rule out appendicitis.

Patient Data

Age: N/A
Gender: Female

Abdominal ultrasound shows right lower quadrant soft tissue nodule deep to the abdominal wall.
It has mixed echogenicity but is predominantly echogenic. This is deep to the abdominal wall in close relation to the peritoneum.


In the right lower quadrant there is a peri and pre-cecal fat stranding but no clear evidence of appendicitis.

Incidental note of one double layer of air that is either in the fold of lower cecum or corresponds to a diverticulum.

There is a sliver of free fluid in the mesentery in the right lower quadrant, that likely represents mesenteric edema.

Case Discussion

When there is a suspicion for mesenteric infarct, one must scrutinize the scan for evidence of thrombosis of the mesenteric arteries and to see if there are other areas of infarct. 

It is important to asses for signs of bowel ischemia such as bowel wall thickening, subtle diffuse hypoenhancement of the bowel wall, pneumatosis intestinalis, or portovenous gas.

Acknowledgement: Dr. Maria Tsatoumas

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