IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Ischemic small bowel

Case contributed by Ian Bickle
Diagnosis certain

Presentation

1-day history of generalized mild abdominal pain. Mild abdominal distension. Diverticulitis?

Patient Data

Age: 75 years
Gender: Female
ct

Long segment of markedly thickened non-enhancing proximal ileum low in the pelvis with surrounding perienteric inflammatory change.

Thrombus in the SMV from its origin and the infrarenal IVC.

Inflammatory change in the small bowel mesentery. 

Small volume intraperitoneal free fluid. No free abdominal gas.

Emergency laparotomy performed

Photo

A 20 cm segment of ischemic proximal ileum found at surgery.

Resection and anastomosis were performed.

Case Discussion

An excellent example of ischemic bowel with surgical confirmation.

The wall is thickened and devoid of enhancement.

In this case the thrombus is also evident in the SMV.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.