File:Bowel ischemia secondary to SMA occlusion with extensive portomesenteric venous gas (Radiopaedia 54656-60871 A 30).jpg

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Bowel_ischemia_secondary_to_SMA_occlusion_with_extensive_portomesenteric_venous_gas_(Radiopaedia_54656-60871_A_30).jpg ‎(512 × 512 pixels, file size: 38 KB, MIME type: image/jpeg)

Summary:

Description
  • Radiopaedia case ID: 54656
  • Image ID: 31599294
  • Image stack position: 30/86
  • Plane projection: Axial
  • Aux modality: C+ arterial phase
  • Modality: CT
  • System: Gastrointestinal
  • Findings: FINDINGS: Contrast enhanced CT shows complete occlusion of the SMA ~4 cm distal to its origin (nicely demonstrated on the VRT reconstruction) with subsequent pneumatosis intestinalis of large portions of the small bowel and the proximal half of the large bowel. Extensive gas filled tributaries of the superior mesenteric vein are seen. Portal venous gas is also visualized, predominantly in the left liver lobe. Wedge-shaped splenic hypoperfusion dorso-apical consistent with a small splenic infarction. Traces of free fluid down the paracolic gutter on the right. Secondary findings include atelectatic lung, a 10 mm left lower lobe pulmonary nodule measuring 10 mm in the left lower lobe dorsally, advanced arteriosclerosis and degenerative as well as osteopenic skeletal changes, renal atrophy with a calcified cyst on the right. CONCLUSION: Fulminant bowel ischemia due to proximal, thromboembolic SMA occlusion resulting in pneumatosis intestinalis, and extensive portomesenteric venous gas.
Date Published: 20th Jul 2017
Source https://radiopaedia.org/cases/bowel-ischaemia-secondary-to-sma-occlusion-with-extensive-portomesenteric-venous-gas
Author Benedikt Beilstein
Permission
(Permission-reusing-text)		 http://creativecommons.org/licenses/by-nc-sa/3.0/

Licensing:

Attribution-NonCommercial-ShareAlike 3.0 Unported (CC BY-NC-SA 3.0)

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