Ischemia can occur with small bowel obstruction (SBO) and result in major complications. It can be identified by findings seen on CT scans. The authors are from Duke University, the University of New Mexico and the New Mexico VA Health Care System.
Patient selection: small bowel obstruction
Exam: CT imaging
Findings associated with ischemia:
(1) thickened bowel wall (> 3 mm)
(2) abnormal bowel wall enhancement (may be decreased or increased)
(3) closed loop obstruction or volvulus
(4) pneumatosis
Mesentery:
(1) mesenteric edema
(2) fluid in the mesentery
(3) occlusion of mesenteric vessels
(4) engorged mesenteric vessels
(5) mesenteric venous gas
(6) whirl sign (swirled configuration of adjacent vessels in the mesentery)
Other findings:
(1) fluid in the peritoneal cavity
(2) gas in the portal veiin
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