Computed tomography of intramural intestinal hemorrhage and bowel ischemia

Abstract

The CT findings of eight patients with intramural intestinal hemorrhage are described and illustrated. Two patients had ischemic bowel disease: in the other six cases pertinent clinical histories led to an accurate diagnosis. Computed tomography demonstrated similar findings consisting of circumferential and symmetrical wall thickening homogeneous in density, a slightly narrowed intestinal lumen, and sharp outer contour. The disease had a segmental distribution affecting different parts of the intestinal tract. In six patients edematous and congestive mesenteric changes were seen and in two patients intraperitoneal blood was detected. An adequate history and careful clinical evaluation are crucial in differentiating the more benign forms of intramural hemorrhage from bowel ischemia.