Intestinal infarction

[surgmcq]

Intestinal infarction all are signs on CT except?

a) Bowel walll thickening

b) Thumbprinting

c) Free Peritoneal air

d) Intramural gas

[surgmcq]

b

The most common CT finding in bowel ischemia is bowel wall thickening, although it is nonspecific. The thickened bowel wall is sometimes associated with the target sign, alternating layers of high and low attenuation within the thickened bowel wall, which results from submucosal edema or hemorrhage. However, the bowel wall is thinned or occasionally invisible when the involved bowel segment becomes gangrenous.

Other CT findings of bowel ischemia reported in the literature include arterial occlusion, mesenteric or portal vein thrombosis, bowel dilatation, engorgement of mesenteric veins and mesenteric edema, intramural gas (intestinal pneumatosis), mesenteric or portal venous gas, lack of bowel wall enhancement, increased enhancement of the thickened bowel wall, and infarction of other abdominal organs

The intramural gas is caused by dissection of luminal gas into the bowel wall across the compromised mucosa.

Mesenteric or portal venous gas is an even less common CT manifestation of ischemic bowel disease and represents the propagation of intramural gas into the mesenteric venous system. Free intraperitoneal gas is an ominous CT sign in ischemic bowel disease because it indicates perforation of an infarcted bowel segment . Absent or poor enhancement of the bowel wall appears to be the most specific finding for bowel ischemia.

Ref: radiographics.rsnajnls.org/cgi/content/full/20/1/29

Thumbprinting is seen in plain Xray Abdomen and Barium studies only.