eMedicine Specialties > Radiology > Gastrointestinal

Mesenteric Ischemia: Follow-up

Author: Mohammad Alobaidi, MD, Diagnostic Radiologist, River Oaks Imaging and Diagnostics, Spencer Radiology
Coauthor(s): S Zafar H Jafri, MBBS, MD, FACR, Associate Clinical Professor of Radiology, Wayne State University School of Medicine; Chief, Section of Body Computed Tomography (CT), William Beaumont Hospital
Contributor Information and Disclosures

Updated: Dec 18, 2008

Intervention

Medicolegal Pitfalls

  • Misdiagnosis of inflammatory or neoplastic mimickers of intestinal ischemia leads to increased morbidity and mortality. Delayed clinical and radiologic diagnosis leads to greater risk of complications, particularly infarction, with associated high mortality rates and poor outcomes.
  • When the diagnosis is not clear initially, close observation of the patient is mandatory and particularly important in an acute emergency. In this situation, proper clinical decision making and meticulous radiologic interpretation can prevent unnecessary surgical procedures or complacency resulting from the apparent hemodynamic stability of the patient.
 


More on Mesenteric Ischemia

Overview: Mesenteric Ischemia
Imaging: Mesenteric Ischemia
Follow-up: Mesenteric Ischemia
Multimedia: Mesenteric Ischemia
References

References

  1. Stamatakos M, Stefanaki C, Mastrokalos D, Arampatzi H, Safioleas P, Chatziconstantinou C, et al. Mesenteric ischemia: still a deadly puzzle for the medical community. Tohoku J Exp Med. Nov 2008;216(3):197-204. [Medline].

  2. Kaushik S, Federle MP, Schur PH, et al. Abdominal thrombotic and ischemic manifestations of the antiphospholipid antibody syndrome: CT findings in 42 patients. Radiology. Mar 2001;218(3):768-71. [Medline].

  3. Cademartiri F, Palumbo A, Maffei E, Martini C, Malagò R, Belgrano M, et al. Noninvasive evaluation of the celiac trunk and superior mesenteric artery with multislice CT in patients with chronic mesenteric ischaemia. Radiol Med. Oct 29 2008;[Medline].

  4. Lee SS, Ha HK, Park SH, Choi EK, Kim AY, Kim JC, et al. Usefulness of computed tomography in differentiating transmural infarction from nontransmural ischemia of the small intestine in patients with acute mesenteric venous thrombosis. J Comput Assist Tomogr. Sep-Oct 2008;32(5):730-7. [Medline].

  5. Ofer A, Abadi S, Nitecki S, Karram T, Kogan I, Leiderman M, et al. Multidetector CT angiography in the evaluation of acute mesenteric ischemia. Eur Radiol. Aug 9 2008;[Medline].

  6. Alpern MB, Glazer GM, Francis IR. Ischemic or infarcted bowel: CT findings. Radiology. Jan 1988;166(1 Pt 1):149-52. [Medline].

  7. Li KC, Dalman RL, Ch''en IY, et al. Chronic mesenteric ischemia: use of in vivo MR imaging measurements of blood oxygen saturation in the superior mesenteric vein for diagnosis. Radiology. Jul 1997;204(1):71-7. [Medline].

  8. Rha SE, Ha HK, Lee SH, et al. CT and MR imaging findings of bowel ischemia from various primary causes. Radiographics. Jan-Feb 2000;20(1):29-42. [Medline].

  9. Taourel PG, Deneuville M, Pradel JA, et al. Acute mesenteric ischemia: diagnosis with contrast-enhanced CT. Radiology. Jun 1996;199(3):632-6. [Medline].

  10. Zalcman M, Sy M, Donckier V, et al. Helical CT signs in the diagnosis of intestinal ischemia in small-bowel obstruction. AJR Am J Roentgenol. Dec 2000;175(6):1601-7. [Medline].

  11. Burkart DJ, Johnson CD, Ehman RL. Correlation of arterial and venous blood flow in the mesenteric system based on MR findings. 1993 ARRS Executive Council Award. AJR Am J Roentgenol. Dec 1993;161(6):1279-82. [Medline].

  12. Baccoli A, Manconi AR, Sau P, Pisu S, Serra C, Sau M. [Duplex US evaluation of mesenteric vessels in acute abdomen. Perspective study on 325 patients]. G Chir. Oct 2008;29(10):449-54. [Medline].

  13. Lim HK, Lee WJ, Kim SH, et al. Splanchnic arterial stenosis or occlusion: diagnosis at Doppler US. Radiology. May 1999;211(2):405-10. [Medline].

  14. Roobottom CA, Dubbins PA. Significant disease of the celiac and superior mesenteric arteries in asymptomatic patients: predictive value of Doppler sonography. AJR Am J Roentgenol. Nov 1993;161(5):985-8. [Medline].

Further Reading

Keywords

mesenteric ischemia, bowel infarction, bowel ischemia, intestinal angina, ischemic colitis, bowel necrosis, bowel ischemia

Contributor Information and Disclosures

Author

Mohammad Alobaidi, MD, Diagnostic Radiologist, River Oaks Imaging and Diagnostics, Spencer Radiology
Mohammad Alobaidi, MD is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, Radiological Society of North America, and Texas Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

S Zafar H Jafri, MBBS, MD, FACR, Associate Clinical Professor of Radiology, Wayne State University School of Medicine; Chief, Section of Body Computed Tomography (CT), William Beaumont Hospital
S Zafar H Jafri, MBBS, MD, FACR is a member of the following medical societies: American College of Radiology, Radiological Society of North America, Society of Radiologists in Ultrasound, and Society of Uroradiology
Disclosure: Nothing to disclose.

Medical Editor

Zahir Amin, MD, MBBS, MRCP, FRCR, Consulting Staff, Department of Imaging, University College Hospital, UK
Zahir Amin, MD, MBBS, MRCP, FRCR is a member of the following medical societies: British Institute of Radiology, British Medical Association, and Royal College of Radiologists
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Spencer B Gay, MD, Professor of Radiology, Director of Body Computed Tomography, Department of Radiology, University of Virginia Health Sciences Center
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Eugene C Lin, MD, Consulting Radiologist, Virginia Mason Medical Center; Clinical Assistant Professor of Radiology, University of Washington School of Medicine
Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, and Society of Nuclear Medicine
Disclosure: Nothing to disclose.

 
 
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