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Computed Tomographic Imaging Findings of Bowel Ischemia

Saba, Luca MD*; Mallarini, Giorgio MD*†

Journal of Computer Assisted Tomography: May-June 2008 - Volume 32 - Issue 3 - p 329-340
doi: 10.1097/RCT.0b013e3180dc8cb1
Abdominal Imaging: Review Article

Learning Objectives: Learning objectives of this paper are to review and to summarize the pathogenesis of bowel ischemia and to describe its clinical, pathological, and radiological manifestations.

Background: Bowel ischemia is a common disorder produced by several causes, and it shows various clinical presentations connected with an high mortality. With the increase in average life expectancy, bowel ischemia represents one of the most threatening abdominal conditions in elderly patients. In the last decade, computed tomography has tremendously altered the diagnostic approach to bowel ischemia also influencing the therapeutic approach in the current practice.

Imaging Findings: Computed tomographic imaging findings include bowel wall thickening, portal venous gas, intramural pneumatosis, engorgement of mesenteric veins, loss or increase of bowel wall enhancement, and infarction of other abdominal organs.

Conclusions: Bowel ischemia shows a broad spectrum of radiological manifestations, and regardless of the primary causes, it produces similar radiological features. Bowel ischemia may simulate cancer or inflammatory conditions; so it is a mandatory tight integration between radiological and clinical signs.

From the *Department of Science of the Images, Policlinico Universitario; and †Institute of Radiology of the University of Cagliari, Cagliari, Italy.

Received for publication February 12, 2007; accepted May 2, 2007.

Reprints: Luca Saba, MD, Department of Science of the Images, Policlinico Universitario, s.s. 554 Monserrato, Cagliari 09045, Italy (e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.