CT Imaging of Acute Bowel Ischemia and Infarction - Department of ...
CT Imaging of Acute Bowel Ischemia and Infarction - Department of ...
CT Imaging of Acute Bowel Ischemia and Infarction - Department of ...
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Pathology<br />
<strong>Ischemia</strong> <strong>and</strong> <strong>Infarction</strong>: Contributing Factors<br />
• 1 = mucosal ischemia<br />
– aka ischemic enteritis/ colitis<br />
– Reversible mucosal erosions <strong>and</strong> ulcerations<br />
Important to realize that acute bowel<br />
ischemia does NOT refer to a single<br />
– Partial mural necrosis entity, with but possible rather repair a spectrum +/- residual <strong>of</strong> disease! fibrotic strictures<br />
• 2 = submucosal/ muscularis ischemia<br />
• 3 = transmural ischemia<br />
– aka bowel infarction<br />
– Non-reversible transmural gangrenous necrosis<br />
• Post-ischemic inflammatory response<br />
– i.e. release <strong>of</strong> a myriad <strong>of</strong> cytokines<br />
– Contributes to necrosis <strong>and</strong> further compromises mucosal integrity<br />
• Super-infection (esp. colon)<br />
– Translocation <strong>of</strong> intra-luminal bacteria, leading to mural infection, bacteremia <strong>and</strong><br />
sepsis (high mortality)
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