Multidetector Computed Tomography in Diagnosis of Mesenteric Vascular ‎Occlusion

Abstract

Background: Multidetector computed tomography (MDCT) has high sensitivity and ‎specificity for diagnosing acute primary mesenteric ischemia (MI). MDCT findings vary ‎widely depending on the cause and underlying pathophysiology. MDCT findings of ‎mesenteric ischemia should be characterized on the basis of the cause‏ ‏that lead to early ‎diagnosis and intervention. Aim: The aim of the study was to assess the impact of different MDCT phases in ‎diagnosis of mesenteric vascular occlusion (MVO).‎ Patients and Methods: This study that was carried out on 20 patients with suspected mesenteric vascular ‎occlusion who were referred to Tanta University Hospitals and General Surgery ‎Department during a period one year starting from May 2018 till May 2019.‎ Results: Out of the 20 studied patients, 11 (55%) of them was male and 9 (45‎‎%) was female, the age of the studied patients ranged from 40 to 73 years old ‎with mean age 57.10 ± 8.85 years. In our study the predisposing factors for MVO were as follow 6 (30%) had ‎Primary thrombosis, 9 (45%) had cirrhosis, 8 (40%) had Portal hypertension, ‎‎4 (20%) had DM, 4 (20%) had Atherosclerosis, and 2 (10%) had ischemic heart ‎disease.‎ Conclusion: Acute and chronic mesenteric ischemia are morbid conditions that are challenging to ‎diagnose. Patients present with variable, nonspecific signs and symptoms, and the ‎physical examination is often benign. A high index of clinical and radiologic suspicion ‎is thus required for diagnosis  MDCT is an accurate, fast, and non-invasive ‎technique which should be used in clinically suspected patients with MVO in order to ‎confirm the diagnosis identify the aetiology and in addition assessing the bowel loop ‎status for adequate management with good prognosis.‎ Familiarity with the MDCT imaging manifestations of mesenteric ischemia allows ‎for a more precise, prompt diagnosis, early institution of therapy and potentially ‎improved patient outcomes.‎