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Acute Intestinal Ischemia in Adults: Evidence-Based Emergency Imaging

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Book cover Evidence-Based Emergency Imaging

Part of the book series: Evidence-Based Imaging ((Evidence-Based Imag.))

Abstract

Acute intestinal ischemia is defined as inadequate blood supply to the gut. It has a high mortality rate, ranging between 32% and 93% depending on etiology. Acute intestinal ischemia may be caused by arterial or venous occlusion or by nonocclusive hypoperfusion states. The incidence increases with age and the majority of patients are over the age of 60. A high index of clinical suspicion is necessary for early detection and treatment of acute intestinal ischemia as signs, symptoms, and laboratory tests for intestinal ischemia are nonspecific. Multidetector computed tomography angiography is highly sensitive and specific in detecting small bowel ischemia and may be used as a first-line imaging method. In patients for whom contrast-enhanced computed tomography is contraindicated, abdominal radiographs are of little value in the diagnosis of intestinal ischemia; however, ultrasound and magnetic resonance angiography may be used as alternative imaging modalities. While surgery is the mainstay of treatment of acute intestinal ischemia, endovascular revascularization can be considered in patients without clinical evidence of peritonitis but with radiological evidence of advanced ischemia and recent onset of symptoms and with a low threshold for converting to open surgery if required.

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Author information

Authors and Affiliations

  1. Department of Radiology, St. Vincent’s University Hospital, Dublin, Ireland

    Lisa P. Lavelle, Sinead H. McEvoy, Anne G. Carroll, Richard G. Kavanagh, Jeffrey W. McCann & Dermot E. Malone

  2. Department of Radiology, Interventional Radiology Resident, Michigan Medicine, Ann Arbor, MI, USA

    Michael Cline

Authors
  1. Lisa P. Lavelle
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  2. Sinead H. McEvoy
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  3. Anne G. Carroll
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  4. Richard G. Kavanagh
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  5. Jeffrey W. McCann
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  6. Dermot E. Malone
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  7. Michael Cline
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Corresponding author

Correspondence to Lisa P. Lavelle .

Editor information

Editors and Affiliations

  1. Department of Radiology, Division of Cardio-Thoracic Radiology, Michigan Medicine, Ann Arbor, MI, USA

    Aine Kelly

  2. Department of Radiology, Division of Cardio-Thoracic Radiology, Michigan Medicine, Ann Arbor, MI, USA

    Paul Cronin

  3. Department of Diagnostic, Interventional, and Pediatric Radiology Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland

    Stefan Puig

  4. Department of Radiology, University of Kentucky Children’s Hospital, Lexington, KY, USA

    Kimberly E. Applegate

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Lavelle, L.P. et al. (2018). Acute Intestinal Ischemia in Adults: Evidence-Based Emergency Imaging. In: Kelly, A., Cronin, P., Puig, S., Applegate, K. (eds) Evidence-Based Emergency Imaging. Evidence-Based Imaging. Springer, Cham. https://doi.org/10.1007/978-3-319-67066-9_24

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  • DOI: https://doi.org/10.1007/978-3-319-67066-9_24

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-67064-5

  • Online ISBN: 978-3-319-67066-9

  • eBook Packages: MedicineMedicine (R0)

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