CT Imaging of Acute Bowel Ischemia and Infarction - Department of ...

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Anatomy Vascular Supply of Bowel: Blood Flow • Percentage of cardiac output received by bowel… – (a) Normal circumstances = 20% – (b) Post-prandial (splanchnic auto-regulation) = 35% – (c) Sympathetic stress response = 10% • Proportion of arterial blood to bowel wall… – 2/3 = mucosa (i.e. susceptible to ischemia) – 1/3 = remainder of the mural layers Ex. Shock = high-risk group (i.e. low flow state + stress response)
Pathology Ischemia and Infarction: Stages • 1 = mucosal ischemia – aka ischemic enteritis/ colitis – Reversible mucosal erosions and ulcerations • 2 = submucosal/ muscularis ischemia – Partial mural necrosis with possible repair +/- residual fibrotic strictures • 3 = transmural ischemia – aka bowel infarction – Non-reversible transmural gangrenous necrosis
Page 1 and 2: CT Imaging of Acute Bowel Ischemia
Page 3 and 4: Anatomy Vascular Supply of Bowel: A
Page 5: Anatomy Vascular Supply of Bowel: V
Page 9 and 10: Pathology Etiologies 1. Occlusive (
Page 11 and 12: Pathology Etiologies: Occlusive SMA
Page 13 and 14: Pathology Etiologies: Occlusive Aor
Page 15 and 16: Pathology Etiologies: Non-occlusive
Page 17 and 18: CT Technique: Ischemic Bowel Protoc
Page 19 and 20: CT Findings: Approach • Distribut
Page 21 and 22: CT Findings: Bowel Thickening • s
Page 23 and 24: CT Findings: Fluid • (a) Fat stra
Page 25 and 26: CT Findings: Air Pneumotosis Portal
Page 27 and 28: CT Findings: Complications • Perf
Page 29 and 30: Cases Case #1: Large bowel ischemia
Page 31 and 32: Cases Case #2: Large bowel ischemia
Page 33 and 34: Cases Case #3: Small bowel Ischemia
Page 35 and 36: Cases Case #4: Small and large bowe
Page 37 and 38: Cases Case #5: Small bowel obstruct
Page 39: Cases 1. 2678623 = large bowel isch

CT Imaging of Acute Bowel Ischemia and Infarction - Department of ...

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