EDITOR'S QUIZ: GI SNAPSHOT
EDITOR’S QUIZ: GI SNAPSHOT
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From question on page 1740
The axial computed tomography (CT) image (fig 1
) shows peripheral fine branching intrahepatic air, consistent with portal venous gas. This was confirmed (arrow) on the coronal reconstructed CT image (fig 2), along with loops of dilated bowel. The coronal image (fig 3) showed reduced contrast enhancement near the origin of the superior mesenteric artery in keeping with occlusion (arrow).
[in a new window] Figure 2 Coronal reconstructed computed tomography image showing portal venous gas, along with loops of dilated bowel.
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[in a new window] Figure 3 Coronal computed tomography image showing reduced contrast enhancement near the origin of the superior mesenteric artery in keeping with occlusion (arrow).
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Mesenteric arterial insufficiency has many causes but the abrupt onset in this case would be suggestive of embolic disease secondary to atrial fibrillation. In cases of mesenteric vascular disease, it is important to differentiate ischaemia from frank luminal infarction because the latter is associated with a dire prognosis.
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Gut 2005 54: 1740.[Extract] [Full Text] [PDF]
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