Computed Tomography (CT) and CT Angiography (CTA) play an important role in the diagnosis of mesenteric ischemia and small bowel obstruction. They enable detailed examination not only of the mesenteric arteries and veins, but also of the small bowel itself, including the wall.
Mesenteric ischemia is a complex condition that is difficult to diagnose clinically. It can be acute or chronic and can occur from a variety of causes. The incidence of mesenteric ischemia increases with age. The etiology of acute mesenteric ischemia in one-half of patients is thrombosis, usually of the superior mesenteric artery. About one third of patients have non-occlusive arterial ischemia. Another cause of acute mesenteric ischemia is mesenteric vein thrombosis.
With negative oral contrast (usually water mixed with another agent) and rapid intravenous injection of contrast, a rapid CT acquisition through the abdomen and pelvis provides data that can be reconstructed into coronal or sagittal images. Pathology including active bleeding, obstruction, ischemia, inflammatory disease, or tumor can be depicted and diagnosed.