Korean J Radiol.  2013 Feb;14(1):38-44. 10.3348/kjr.2013.14.1.38.

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

• Wong YC
• Wu CH
• Wang LJ
• Chen HW
• Lin BC
• Huang CC

• KMID: 1430042
• DOI: http://doi.org/10.3348/kjr.2013.14.1.38

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.

Keyword

CT; Superior mesenteric artery thromboembolism; Superior mesenteric vein thrombosis; Life-threatening mesenteric occlusion; Independent finding

MeSH Terms

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