title: Intestinal Ischemia: US-CT findings correlations.
abstract: BACKGROUND
  Intestinal ischemia is an abdominal emergency that accounts for approximately 2% of gastrointestinal illnesses. It represents a complex of diseases caused by impaired blood perfusion to the small and/or large bowel including acute arterial mesenteric ischemia (AAMI), acute venous mesenteric ischemia (AVMI), non occlusive mesenteric ischemia (NOMI), ischemia/reperfusion injury (I/R), ischemic colitis (IC). In this study different study methods (US, CT) will be correlated in the detection of mesenteric ischemia imaging findings due to various etiologies.
  
  
  METHODS
  Basing on experience of our institutions, over 200 cases of mesenteric ischemia/infarction investigated with both US and CT were evaluated considering, in particular, the following findings: presence/absence of arterial/venous obstruction, bowel wall thickness and enhancement, presence/absence of spastic reflex ileus, hypotonic reflex ileus or paralitic ileus, mural and/or portal/mesenteric pneumatosis, abdominal free fluid, parenchymal ischemia/infarction (liver, kidney, spleen).
  
  
  RESULTS
  To make an early diagnosis useful to ensure a correct therapeutic approach, it is very important to differentiate between occlusive (arterial,venous) and nonocclusive causes (NOMI). The typical findings of each forms of mesenteric ischemia are explained in the text.
  
  
  CONCLUSIONS
  At present, the reference diagnostic modality for intestinal ischaemia is contrast-enhanced CT. However, there are some disadvantages associated with these techniques, such as radiation exposure, potential nephrotoxicity and the risk of an allergic reaction to the contrast agents. Thus, not all patients with suspected bowel ischaemia can be subjected to these examinations. Despite its limitations, US could constitutes a good imaging method as first examination in acute settings of suspected mesenteric ischemia.
authors.affiliation: Second University of Naples, Department of Clinical and Experimental Internistic F, Magrassi - A, Lanzara, Naples, Italy. reginelli@tin.it.
authors.forename: A
authors.initials: A
authors.lastname: Reginelli
authors.forename: Ea
authors.initials: E
authors.lastname: Genovese
authors.forename: S
authors.initials: S
authors.lastname: Cappabianca
authors.forename: F
authors.initials: F
authors.lastname: Iacobellis
authors.forename: D
authors.initials: D
authors.lastname: Berritto
authors.forename: P
authors.initials: P
authors.lastname: Fonio
authors.forename: F
authors.initials: F
authors.lastname: Coppolino
authors.forename: R
authors.initials: R
authors.lastname: Grassi
references.citation: Ann Vasc Surg. 2011 Aug;25(6):840.e1-4
references.pmid: 21620665
references.citation: Cleve Clin J Med. 2009 Jul;76(7):401-9
references.pmid: 19570972
references.citation: Arch Surg. 1990 May;125(5):591-4
references.pmid: 2331215
references.citation: Am J Gastroenterol. 2007 Oct;102(10):2247-52
references.pmid: 17561968
references.citation: Proc R Soc Med. 1961 May;54:354-6
references.pmid: 13694510
references.citation: J Ultrasound. 2010 Sep;13(3):118-22
references.pmid: 23396804
references.citation: Recenti Prog Med. 2012 Nov;103(11):542-5
references.pmid: 23096749
references.citation: JBR-BTR. 2009 Jul-Aug;92(4):202-6
references.pmid: 19803098
references.citation: Chirurg. 1989 Jun;60(6):419-25
references.pmid: 2758894
references.citation: Emerg Radiol. 2011 Oct;18(5):385-94
references.pmid: 21655965
references.citation: AJR Am J Roentgenol. 2009 Feb;192(2):408-16
references.pmid: 19155403
references.citation: J Radiol. 2001 Nov;82(11):1645-9
references.pmid: 11894552
references.citation: Mayo Clin Proc. 1989 Sep;64(9):1158-69
references.pmid: 2682055
references.citation: Br J Radiol. 2007 Aug;80(956):603-8
references.pmid: 17681988
references.citation: J Vasc Surg. 1993 Apr;17(4):738-45
references.pmid: 8464094
references.citation: Surg Today. 2005;35(3):185-95
references.pmid: 15772787
references.citation: Radiol Med. 2011 Sep;116(6):829-41
references.pmid: 21509555
references.citation: Emerg Radiol. 2011 Apr;18(2):145-56
references.pmid: 21132342
references.citation: Recenti Prog Med. 2012 Nov;103(11):422-5
references.pmid: 23096724
references.citation: World J Gastroenterol. 2008 Dec 28;14(48):7302-8
references.pmid: 19109863
references.citation: Radiol Clin North Am. 2008 Jul;46(4):755-71, vi
references.pmid: 18922291
references.citation: Radiol Clin North Am. 2008 Sep;46(5):877-85, v
references.pmid: 19103137
references.citation: Infez Med. 2012;20 Suppl 1:14-9
references.pmid: 22982693
references.citation: Eur J Radiol. 2004 Apr;50(1):5-14
references.pmid: 15093230
references.citation: J Ultrasound Med. 2009 May;28(5):641-50
references.pmid: 19389903
references.citation: Radiology. 2006 Sep;240(3):623-38
references.pmid: 16926320
references.citation: Eur J Radiol. 2007 Mar;61(3):433-41
references.pmid: 17157468
references.citation: Semin Vasc Surg. 2001 Sep;14(3):186-92
references.pmid: 11561279
references.citation: Best Pract Res Clin Gastroenterol. 2001 Feb;15(1):83-98
references.pmid: 11355902
references.citation: Abdom Imaging. 2012 Dec;37(6):1066-73
references.pmid: 22289996
references.citation: Radiol Clin North Am. 2008 Sep;46(5):845-75, v
references.pmid: 19103136
references.citation: J Korean Soc Coloproctol. 2011 Dec;27(6):282-6
references.pmid: 22259742
references.citation: Recenti Prog Med. 2012 Nov;103(11):552-4
references.pmid: 23096752
references.citation: Semin Ultrasound CT MR. 2012 Aug;33(4):308-17
references.pmid: 22824121
references.citation: Eur Radiol. 2002 May;12(5):1179-87
references.pmid: 11976865
references.citation: Radiology. 2003 Mar;226(3):635-50
references.pmid: 12601205
references.citation: Zentralbl Chir. 2000;125(2):144-51
references.pmid: 10743034
references.citation: World J Gastroenterol. 2013 Mar 7;19(9):1338-41
references.pmid: 23538325
references.citation: Emerg Med Clin North Am. 2004 Nov;22(4):909-28
references.pmid: 15474776
references.citation: Eur Radiol. 2010 Jan;20(1):138-45
references.pmid: 19504100
references.citation: Semin Vasc Surg. 1999 Dec;12(4):252-60
references.pmid: 10651454
references.citation: Eur J Radiol. 2004 Apr;50(1):37-47
references.pmid: 15093234
references.citation: Br J Radiol. 2008 Mar;81(963):252-7
references.pmid: 18180262
references.citation: Radiol Clin North Am. 2008 Sep;46(5):891-908, vi
references.pmid: 19103139
references.citation: Eur J Drug Metab Pharmacokinet. 2011 Jan;35(3-4):89-95
references.pmid: 21302034
references.citation: J Ultrasound. 2011 Mar;14(1):10-3
references.pmid: 23396864
references.citation: Abdom Imaging. 2004 Jan-Feb;29(1):18-22
references.pmid: 15160748
references.citation: Recenti Prog Med. 2012 Nov;103(11):493-9
references.pmid: 23096738
references.citation: Diagn Interv Radiol. 2009 Dec;15(4):256-61
references.pmid: 19813174
references.citation: World J Gastroenterol. 2012 Apr 7;18(13):1496-501
references.pmid: 22509081
references.citation: Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir. 1990;:317-21
references.pmid: 1983565
references.citation: Emerg Radiol. 2008 Jan;15(1):1-11
references.pmid: 17960437
references.citation: J Comput Assist Tomogr. 2012 Jan-Feb;36(1):1-7
references.pmid: 22261763
references.citation: Radiographics. 2002 Jul-Aug;22(4):863-79; discussion 879-80
references.pmid: 12110715
references.citation: Zentralbl Chir. 1998;123(12):1411-7
references.pmid: 10063555
references.citation: Semin Ultrasound CT MR. 2012 Aug;33(4):379-82
references.pmid: 22824127
references.citation: Abdom Imaging. 2006 May-Jun;31(3):277-92
references.pmid: 16283583
references.citation: J Pediatr. 2013 Jun;162(6):1188-92
references.pmid: 23312678
references.citation: Emerg Radiol. 2010 Sep;17(5):361-5
references.pmid: 20393776
references.citation: Recenti Prog Med. 2012 Nov;103(11):510-4
references.pmid: 23096741
references.citation: Magn Reson Imaging. 2013 Apr;31(3):408-13
references.pmid: 23102942