Presentation
Presented to ER with acute abdominal pain, vomiting and distention
Patient Data
Long segment bowel wall thickening involving the distal jejunal, proximal ileal loops with diffuse wall thickening showing mucosal enhancement, submucosal edema and faint serosal enhancement giving a target appearance. Maximum bowel wall thickness measures 15 mm. Mesenteric thickening with vessel engorgement seen at the site of involvement. Distal ileal loops are collapsed with wall thickening of 9.0 mm. Few lymph nodes seen within the mesentery.
SMA and SMV appears patent.
IVC is collapsed.
o The jejunal loops proximal to the wall thickening are dilated in caliber, maximum diameter measures 4.0 cm.
o Mild degree free fluid
o Large bowel is collapse and appears normal.
Long segment bowel ischemia of of jejunal and ileal loops.
Case Discussion
Diffuse bowel wall thickening and bowel ischemia is seen with patent mesenteric arteries and veins (non occluded vessels) is caused due to slow delivery of oxygenated blood to the intestines.It can also be caused by low mesentric flow with secondary reflex of mesentric arterial vasoconstriction
Hypoperfusion results in increased bowel permeability to macro molecules and albumin leading to wall thickening.
Patient had pacemaker inserted for arrhythmias.
Laparotomy confirmed the bowel ischemia.
Unable to process the form. Check for errors and try again.