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Update in Radiology
Acute mesenteric ischemia: A review of the main imaging techniques and signs
Isquemia mesentérica aguda: Revisión de las principales técnicas y signos radiológicos
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R. Navas-Campoa,
Corresponding author
raquelnavascampo@gmail.com

Corresponding author.
, L. Moreno-Caballeroa, A. Ezponda Casajúsb, D. Ibáñez Muñoza
a Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
b Clínica Universidad de Navarra, Navarra, Pamplona, Spain
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Received 27 January 2019. Accepted 11 February 2020
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Table 1. Distribution of arterial vascularisation of the different intestinal regions and collateral circuits.
Table 2. Incidence, symptoms and risk factors by aetiology of acute mesenteric ischaemia.
Table 3. Findings on multidetector CT by aetiology of acute mesenteric ischaemia.
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Abstract

Acute mesenteric ischaemia is an abdominal emergency because reduced blood flow to bowel loops rapidly leads to irreversible necrosis and death.

This paper reviews the different conditions (arterial, venous, low-flow states) that can result in reduced blood flow to bowel loops.

Since the clinical and laboratory findings are nonspecific, imaging tests play an important role in the diagnosis of mesenteric ischaemia. Multidetector computed tomography is the first-choice technique for the initial workup in cases of suspected acute mesenteric ischaemia because it can rule out other causes of acute abdominal pain. It is important to know the characteristic radiological signs of this entity, because early diagnosis is essential to prevent progression to life-threatening intestinal necrosis.

Keywords:
Acute mesenteric ischaemia
Occlusive (arterial) mesenteric ischaemia
Mesenteric venous thrombosis
Non-occlusive mesenteric ischaemia
Multidetector computed tomography
Resumen

La isquemia mesentérica aguda constituye una urgencia abdominal con elevada mortalidad, debido al escaso tiempo que transcurre desde la disminución del flujo vascular a las asas intestinales hasta la instauración de una necrosis intestinal irreversible.

Esta disminución del flujo puede deberse a diferentes causas, objeto de revisión de este estudio (arteriales, venosas y estados de bajo gasto).

Las pruebas de imagen tienen un importante papel en su diagnóstico, ya que ni los síntomas ni las pruebas de laboratorio son específicos. La tomografía computarizada multidetector (TCMD) es la técnica de imagen inicial de elección para el diagnóstico de sospecha de la isquemia mesentérica aguda y permite excluir otras causas de dolor abdominal agudo. Es importante conocer los signos radiológicos típicos de esta enfermedad, ya que resulta imprescindible su reconocimiento precoz para evitar la progresión de la enfermedad a necrosis intestinal, que puede poner en riesgo la vida del paciente.

Palabras clave:
Isquemia mesentérica aguda
Isquemia mesentérica oclusiva arterial
Trombosis venosa mesentérica
Isquemia mesentérica no oclusiva
Tomografía computarizada multidetector

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