Presentation
Diffuse abdominal pain.
Patient Data
There is a long segment of the small bowel in the central abdomen and pelvis (distal jejunum/proximal ileum) that shows diffuse circumferential thickening and hypoenhancement. It is associated with mesenteric oedema.
The superior mesenteric artery (SMA) shows distal cut-off and absent contrast filling of the terminal SMA, which is feeding the abnormal bowel.
The proximal SMA and its other branches (including ileocolic and jejunal branches) show normal contrast filling.
No pneumatosis intestinalis or pneumoperitoneum.
The remaining bowel appears unremarkable.
Case Discussion
The presence of small bowel thickening along with the lack of enhancement of the distal SMA and some of its branches suggests acute mesenteric ischaemia.
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