Mesenteric Vascular Occlusion: Comparison of Ancillary CT Findings between Arterial and Venous Occlusions and Independent CT Findings Suggesting Life-Threatening Events.

Yon Cheong Wong; Cheng Hsien WU; Li Jen Wang; Huan Wu Chen; Being Chuan Lin; Chen Chih Huang

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Mesenteric Vascular Occlusion: Comparison of Ancillary CT Findings between Arterial and Venous Occlusions and Independent CT Findings Suggesting Life-Threatening Events.

Author: Yon Cheong WONG ¹ ; Cheng Hsien WU ; Li Jen WANG ; Huan Wu CHEN ; Being Chuan LIN ; Chen Chih HUANG
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1. Division of Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan. ycwong@adm.cgmh.org.tw
Publication Type:Comparative Study ; Original Article
Keywords: CT; Superior mesenteric artery thromboembolism; Superior mesenteric vein thrombosis; Life-threatening mesenteric occlusion; Independent finding
MeSH: Arteries; Contrast Media/diagnostic use; Female; Humans; Iohexol/diagnostic use; Male; Mesenteric Vascular Occlusion/mortality/pathology/*radiography; Middle Aged; Multivariate Analysis; Retrospective Studies; Risk Factors; Tomography, X-Ray Computed/*methods; Veins
From:Korean Journal of Radiology 2013;14(1):38-44
CountryRepublic of Korea
Language:English
Abstract: OBJECTIVE: To compare the ancillary CT findings between superior mesenteric artery thromboembolism (SMAT) and superior mesenteric vein thrombosis (SMVT), and to determine the independent CT findings of life-threatening mesenteric occlusion. MATERIALS AND METHODS: Our study was approved by the institution review board. We included 43 patients (21 SMAT and 22 SMVT between 1999 and 2008) of their median age of 60.0 years, and retrospectively analyzed their CT scans. Medical records were reviewed for demographics, management, surgical pathology diagnosis, and outcome. We compared CT findings between SMAT and SMVT groups. Multivariate analysis was conducted to determine the independent CT findings of life-threatening mesenteric occlusion. RESULTS: Of 43 patients, 24 had life-threatening mesenteric occlusion. Death related to mesenteric occlusion was 32.6%. A thick bowel wall (p < 0.001), mesenteric edema (p < 0.001), and ascites (p = 0.009) were more frequently associated with SMVT, whereas diminished bowel enhancement (p = 0.003) and paralytic ileus (p = 0.039) were more frequent in SMAT. Diminished bowel enhancement (OR = 20; p = 0.007) and paralytic ileus (OR = 16; p = 0.033) were independent findings suggesting life-threatening mesenteric occlusion. CONCLUSION: The ancillary CT findings occur with different frequencies in SMAT and SMVT. However, the independent findings indicating life-threatening mesenteric occlusion are diminished bowel wall enhancement and paralytic ileus.