Ischemic bowel

Case contributed by Dr Ian Bickle

Presentation

Elderly patient on medical ward with vague tummy pain.

Patient Data

Age: 85
Gender: Female
CT

Ischemic bowel with perforation:

- pneumoperitoneum with falciform ligament illustrated

- intramural gas

- portal venous gas and gas in SMV

- non-enhancing bowel

- peritoneal free fluid

Case Discussion

Textbook example of the very extreme side of the spectrum of CT findings in acute intestinal ischemia.

The classic features are present:

- Portal venous and SMV gas: see the air-contrast level in the SMV.

- Multiple loops of bowel with intramural air

- Non enhancing bowel

and in this case a perforation has occurred.

The patient deceased within 10 hours of the CT study.

 

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Case information

rID: 29031
Published: 28th Apr 2014
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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