Fig. 20

A 45 y/o female with remote prior bowel resection for malignancy presenting with abdominal pain and distension. a–d Intermediate to late imaging findings of ischemia with dilated small bowel loops with lack of wall enhancement (thick arrows), small bowel-feces sign and minimal pneumatosis (thin arrow), adjacent mesenteric fat stranding and mild interloop fluid. Additionally, the bowel wall is paper-thin (dotted arrow) in the likely necrotic segment with narrowing at two transition points (arrowheads) due to adhesion bands, compatible with closed-loop obstruction. Normal enhancing jejunum (curved arrow) is seen. e Corresponding necrotic closed loop of bowel was evident on laparotomy