Fig. 13
From: Many faces of acute bowel ischemia: overview of radiologic staging
A 54 y/o male with chronic kidney disease undergoing hemodialysis presented with recent abdominal pain and constipation. a There is complete SMV thrombosis (arrowhead) leading to extensive ischemic changes in small bowel loops. b Hyperdense circumferential mural thickening (thick arrow) secondary to intramural hemorrhage is seen. c Mesenteric engorgement is evident (white box). d There are also mural pneumatosis, thinning and hypodensity (thin arrow) consistent with late-stage ischemia. Free fluid in abdomen and pelvis (asterisks) and mesenteric edema (dotted arrow) are also depicted. Intra operative images display prominent mesenteric veins (black box) due to engorgement (e) associated with small bowel necrosis (f)