EURORAD ESR

Case 9093

Small bowel ischaemia with intestinal and portomesenteric pneumatosis

Author(s)
Noguera JJ1, Gomez-Ayechu M2, Martín-Cuartero J1, Ros A3, Moras N4, Riu J2.
Departments of Radiology1, Anesthesia2, Emergency Medicine3 and General Surgery4.
Hospital Reina Sofía, Tudela - SPAIN
 
Patient
male, 77 year(s)
 
 
  • Figure 1
    Ultrasound
     

    Tiny bubbles of gas visible as small echogenic foci in the liver, including subcapsular region (yellow arrows). Liver capsule (white arrows), gallbladder (gb).

     
    Area of Interest: Liver; Imaging Technique: Ultrasound;

    Portal venous gas visible as echogenic foci within portal vein with rapid hepatopetal movement (yellow arrows). Gallbladder (gb).

     
    Area of Interest: Portal system / Hepatic veins; Imaging Technique: Ultrasound;
     
     
  • Figure 2
    Contrast enhanced CT
     

    Coronal reformation. Gas bubbles within the wall of small bowel loops (pneumatosis intestinalis, white arrows).

     
    Area of Interest: Small bowel; Imaging Technique: CT; Special Focus: Ischaemia / Infarction;

    Sagittal reformation. Gas bubbles within the wall of small bowel loops (pneumatosis intestinalis, white arrows).

     
    Area of Interest: Small bowel; Imaging Technique: CT; Special Focus: Ischaemia / Infarction;
     
     
  • Figure 3
    Contrast enhanced CT
     

    Sagittal reformation. Gas within peripheral mesenteric veins (blue arrows).

     
    Area of Interest: Veins / Vena cava; Imaging Technique: CT; Special Focus: Embolism / Thrombosis; Ischaemia / Infarction;

    Sagittal reformation. Gas within mesenteric veins (blue arrows).

     
    Area of Interest: Veins / Vena cava; Imaging Technique: CT; Special Focus: Embolism / Thrombosis; Ischaemia / Infarction;

    Axial view. Gas within superior mesenteric vein (blue arrow). Duodenal diverticulum (asterisk).

     
    Area of Interest: Veins / Vena cava; Imaging Technique: CT; Special Focus: Embolism / Thrombosis; Ischaemia / Infarction;
     
     
  • Figure 4
    Contrast enhanced CT

    Sagittal curved reformation. Intense atheromatosis of superior mesenteric artery causing intestinal ischemia.

     
    Area of Interest: Arteries / Aorta; Imaging Technique: CT; Procedure: Computer Applications-3D; Special Focus: Arteriosclerosis; Ischaemia / Infarction;
     
     
  • Figure 5
    Contrast enhanced CT
     

    Axial view. Gas within intrahepatic portal vein branches. Note that gas bubbles reach subcapsular region (yellow arrows).

     
    Area of Interest: Liver; Imaging Technique: CT; Special Focus: Embolism / Thrombosis; Ischaemia / Infarction;

    Coronal reformation. Gas within intrahepatic portal branches (yellow arrows).

     
    Area of Interest: Liver; Imaging Technique: CT; Special Focus: Embolism / Thrombosis; Ischaemia / Infarction;
     
     
Tiny bubbles of gas visible as small echogenic foci in the liver, including subcapsular region (yellow arrows). Liver capsule (white arrows), gallbladder (gb).
 
Portal venous gas visible as echogenic foci within portal vein with rapid hepatopetal movement (yellow arrows). Gallbladder (gb).
 
Coronal reformation. Gas bubbles within the wall of small bowel loops (pneumatosis intestinalis, white arrows).
 
Sagittal reformation. Gas bubbles within the wall of small bowel loops (pneumatosis intestinalis, white arrows).
 
Sagittal reformation. Gas within peripheral mesenteric veins (blue arrows).
 
Sagittal reformation. Gas within mesenteric veins (blue arrows).
 
Axial view. Gas within superior mesenteric vein (blue arrow). Duodenal diverticulum (asterisk).
 
Sagittal curved reformation. Intense atheromatosis of superior mesenteric artery causing intestinal ischemia.
 
Axial view. Gas within intrahepatic portal vein branches. Note that gas bubbles reach subcapsular region (yellow arrows).
 
Coronal reformation. Gas within intrahepatic portal branches (yellow arrows).
 
 
 
Home Search Sections Teaching Cases History FAQ Case Archives Contact Login Disclaimer Imprint Switch to MOBILE version
View desktop version