CT Of Acute Bowel Ischemia

Purpose:(1) To analyze the CT signs of acute bowel ischemia(ABI) and the relevance to acute enteric necrosis.(2) To discuss the correlation of mesenteric arterial thrombi and acute enteric necrosis.Materials and Methods: From January 2006 to February 2014 in Tianjin Medical University General Hospital, 206 cases with ABI proved by operations or autopsy were included by searching the CT examination record of patients. The data were divided into two groups:43 cases acute enteric necrosis as experimental group, 163 cases without acute enteric necrosis as control group. Firstly, CT signs of each group were respectively collected. Secondly, these data were analyzed using X2 test to find out the relevant imaging manifestations that influence the occurrence of acute enteric necrosis and the operation strategy, meanwhile evaluate the accuracy, sensitivity and specificity of intestinal necrosis in adult. Thirdly, the distance of mesenteric venous thrombosis head to the injection of portal veins was measured in 181(MVT) cases. Fourthly, according to the previous distance measured, the superior mesenteric vein was divided into three parts, and represented with one to three “+”, four pluses”+” appeared when distal branches of superior mesenteric vein revealed filling defect. In this way can we analyze the relation of thrombus location and acute enteric necrosis. Results: superior mesenteric artery filling defect,Superior mesenteric vein filling defect, intestinal pneumatosis dilated, bowel wall thickening, bowel wall enhancement, Mesenteric edema ascites, pneumatosis intestinalis and Portal venous gas, these 9 imaging manifestations has relation with enteric necrosis and operation strategy. The following four representations have closely relation with enteric necrosis, respectively they are pneumatosis intestinalis and portal venous gas, superior mesenteric artery filling defect, superior mesenteric vein filling defect. The experiment shows the greater the distance between the mesenteric venous thrombosis head and the injection of portal veins the higher the enteric necrosis occurred. When the distal branches thrombosis occurred the highest the enteric necrosis happened.Conclusion For the clinically diagnosed cases with ABI, if CT signs show Pneumatosis intestinalis and Portal venous gas and Superior mesenteric vein filling defect and uperior mesenteric artery filling defect, the occurrence of enteric necrosis should be first consideration. The lower the thrombosis of superior mesenteric vein, especially when the distal branches thrombosis appeared, we should aware the occurrence of enteric necrosis and the operation should be done if necessary.