Small bowel/mesenteric ischemia due to SMA embolus
Updates to Study Attributes
Focal eccentric narrowing at the SMA origin. Additional clot in the mid SMA extending into leftward projecting jejunal branches. These branches supply abnormalthickened and hypoenhancing small bowel loops. There is abrupt transition from enhancement to nonenhancing small bowel in these segments, best appreciated on the coronal reformatted images.
Image 67 CT (Axial) ( create )
Image 67 CT (Axial) ( create )
Image 67 CT (Axial) ( create )
Image 67 CT (Axial) ( create )
Image 76 CT (Coronal) ( create )
Updates to Case Attributes
Acute SMA embolus resulting in long segments of jejunal ischemiaischaemia and infarction. The suspected cause was the narrowing at the SMA origin which was felt to be a probable dissection which caused the distal emboli. It is unclear why this occurred, as it could be spontaneous or related to segmental medial arteriolysis.
Notice the downstream small bowel loops (jejunum) which characteristic findings of arterial ischemiaischaemia with reperfusion injury. Specifically, there is abrupt cutoff from enhancing bowel to nonenhancing bowel typical of embolic ischemiaischaemia to the distal branches, and also thickening, which occurs after some reperfusion is restored and there is injury to the bowel wall. This patient underwent resection of small bowel and embolectomy with a complex post-operative course.
-<p>Acute SMA embolus resulting in long segments of jejunal ischemia and infarction. The suspected cause was the narrowing at the SMA origin which was felt to be a probable dissection which caused the distal emboli. It is unclear why this occurred, as it could be spontaneous or related to segmental medial arteriolysis. </p><p>Notice the downstream small bowel loops (jejunum) which characteristic findings of arterial ischemia with reperfusion injury. Specifically, there is abrupt cutoff from enhancing bowel to nonenhancing bowel typical of embolic ischemia to the distal branches, and also thickening, which occurs after some reperfusion is restored and there is injury to the bowel wall. This patient underwent resection of small bowel and embolectomy with a complex post-operative course. </p>- +<p>Acute SMA embolus resulting in long segments of jejunal ischaemia and infarction. The suspected cause was the narrowing at the SMA origin which was felt to be a probable dissection which caused the distal emboli. It is unclear why this occurred, as it could be spontaneous or related to segmental medial arteriolysis. </p><p>Notice the downstream small bowel loops (jejunum) which characteristic findings of arterial ischaemia with reperfusion injury. Specifically, there is abrupt cutoff from enhancing bowel to nonenhancing bowel typical of embolic ischaemia to the distal branches, and also thickening, which occurs after some reperfusion is restored and there is injury to the bowel wall. This patient underwent resection of small bowel and embolectomy with a complex post-operative course. </p>
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