Computed tomography of bowel infarction

Abstract

Bowel infarction is a potentially lethal disorder that is notoriously difficult to diagnose clinically and radiographically. Computed tomography is often used in the early radiographic evaluation of patients with severe abdominal pain of unknown etiology. This study defines the CT findings in patients with bowel infarction. The findings in 22 patients with mesenteric infarction were reviewed. Seven were due to mesenteric arterial occlusion, six due to mesenteric venous occlusion, and nine were nonocclusive. The CT abnormalities were diffuse or focal bowel wall thickening (19 patients), bowel dilatation without mural thickening (three patients), intramural low attenuation zones of edema (eight patients), intramural gas (11 patients), mesenteric gas (five patients), portal or mesenteric venous gas (one patient), mesenteric vascular occlusion (eight patients), and peritoneal gas or fluid (12 patients). The diagnosis of bowel infarction must be considered when performing CT in patients with abdominal pain of unknown etiology.