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Insights into Imaging
Fig. 2 | Insights into Imaging

Fig. 2

From: Reperfusion injury on computed tomography following endovascular revascularization of acute mesenteric ischemia: prevalence, risk factors, and patient outcome

Fig. 2

A 25-year-old male patient presented with early acute mesenteric ischemia (embolus of the superior mesenteric artery, SMA). Decrease in enhancement of the small bowel (arrow) compared to non-ischemic ones (arrowheads) on baseline CT portal-venous phase (a) with complete occlusion of the distal branches of the SMA (b). Complete recanalization of the SMA by thrombus-aspiration and in situ thrombolysis (c). Contrast-enhanced CT (portal venous phase) performed 12 h after revascularization for systematic post-procedural evaluation showed a thickened jejunal loop (arrow) with hyperenhancement of the mucosa and edema of the submucosa consistent with reperfusion injury (d). 24 h after revascularization, the patient has bloody diarrhea with anemia. On portal-venous phase CT, the previously thickened small bowel segment showed marked thickening with intra-luminal hyperattenuating material consistent with hemorrhage (arrow) and mesenteric fat stranding (arrowhead) (e). The patient was closely monitored surveillance, and no laparotomy was needed

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