Acute Mesenteric Ischemia: Multidetector CT Findings and Endovascular Management

Radiographics. 2018 May-Jun;38(3):945-961. doi: 10.1148/rg.2018170163.

Abstract

Acute mesenteric ischemia is a rare life-threatening condition that accounts for approximately one in 1000 hospital admissions. The mortality rate is 50%-69% owing to the absence of specific symptoms and laboratory data, which makes early detection of this condition difficult. If the use of contrast material is possible, biphasic contrast material-enhanced multidetector computed tomography (CT) is the first-line imaging test for early diagnosis of the disease and for differentiation from other causes of acute abdomen. Multidetector CT can depict mesenteric ischemia, its underlying causes, and its severity. Mesenteric ischemia is classified as either acute or chronic. The causes of AMI include arterial embolism, arterial thrombosis, venous thrombosis, and nonocclusive mesenteric ischemia, among which arterial causes are far more common than venous causes. Recently, endovascular procedures such as thrombolysis, thrombectomy, thrombus fragmentation, and stent placement have been successfully and safely performed when the ischemia is reversible. Online DICOM image stacks are available for this article. ©RSNA, 2018.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Endovascular Procedures*
  • Humans
  • Mesenteric Ischemia / diagnostic imaging*
  • Mesenteric Ischemia / surgery*
  • Multidetector Computed Tomography*