Overview
Acute bowel infarction involves the death of bowel tissue due to inadequate blood supply, often leading to severe abdominal pain and potentially life-threatening complications. Early diagnosis is crucial for improving outcomes 2.Diagnosis
Key CT findings: Diffuse or focal bowel wall thickening, bowel dilatation without mural thickening, intramural low attenuation zones, intramural gas, mesenteric gas, portal or mesenteric venous gas, mesenteric vascular occlusion, and peritoneal gas or fluid 2.
Exclusion of mimics: CT helps differentiate from conditions like intraabdominal abscess, pancreatitis, and ulcerative colitis 12.
Unique findings: Presence of splenic air embolism may indicate bowel infarction, though rare 1.Management
Surgical intervention: Primary treatment often involves urgent surgical exploration and resection of infarcted bowel segments 2.
Supportive care: Management includes fluid resuscitation, monitoring for sepsis, and addressing hemodynamic instability 2.
Specific drug therapy: No specific drug doses mentioned in the abstracts; focus on supportive care measures 2.Special Populations
No specific data: The provided abstracts do not cover management specifics for pregnancy, pediatrics, elderly, or comorbidities 12.Key Recommendations
Utilize CT imaging early in patients with severe abdominal pain of unknown etiology to diagnose bowel infarction (Evidence: Moderate 2).
Consider bowel infarction in the differential diagnosis when CT reveals characteristic bowel wall abnormalities and vascular occlusions (Evidence: Moderate 2).
Urgent surgical intervention is recommended for confirmed cases of bowel infarction to prevent further complications (Evidence: Expert opinion 2).References
1 Frola C, Cantoni S, Turtulici I, Loria F. Case report: bowel infarction with splenic air embolism: computed tomography findings. The British journal of radiology 1994. link
2 Clark RA. Computed tomography of bowel infarction. Journal of computer assisted tomography 1987. link