Presentation
Abdominal pain and vomiting, raised CRP and serum lactate
Patient Data
A filling defect is seen in the ileal tributaries draining to the superior mesenteric vein with mesenteric congestion and stranding.
Affected bowel loops show edematous thickened walls with hyperenhancement giving target sign appearance. They are dilated and fluid filled. No pneumatosis. No pneumoperitoneum.
Minimal ascites is seen.
Incidental right renal parapelvic cyst.
Case Discussion
Veno-occlusive mesenteric ischemia is less common than arterial ischemia and it is sometimes called wet ischemia as there will be more mesenteric congestion, stranding and ascites.
It is expected that markedly congested bowel walls will have decreased motility and thus a degree of functional obstruction will be seen.
If you have unenhanced phase, compare the density of the affected bowel walls as they are susceptible to intramural hemorrhage.