La Radiologia medica
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La Radiologia medica · Apr 1999
[Computerized tomography features of intestinal infarction: 56 surgically treated patients of which 5 with reversible mesenteric ischemia].
Bowel infarction is a rare and typical condition of the elderly; despite improvements in diagnostic imaging and vascular surgery, bowel infarction remains a major cause of acute abdomen, with mortality rates ranging 70-80%. Diagnosis is often late because clinical signs, laboratory data and radiologic findings are aspecific. We investigated radiographic and particularly CT patterns of intestinal infarction in 56 patients submitted to surgery within 12 hours of admission. We also report the CT findings of 5 of these patients who had reversible mesenteric ischemia. ⋯ Angiography is a valuable imaging and treatment technique permitting the diagnosis of vascular occlusion and the intraarterial infusion of vasodilators, but it can be carried out in emergency in few centers only. This makes conventional radiology, and particularly CT, the only tool providing useful information for early diagnosis and treatment of bowel infarction. CT is more sensitive than radiography and does not exhibit the limitations of angiography--i.e., invasiveness, radiation exposure and complex organization. Therefore CT can presently be considered the method of choice in patients with suspected bowel infarction.