The role of computed tomography in the diagnosis of acute intestinal ischemia

Early detection of acute intestinal ischemia has the most important prognostic impact on the outcome of affected patients. Computed tomography is not only an imaging modality to resolve the broad differential diagnosis of the acute abdomen but has, in the last few years, also proven to play a central role in the detection of acute intestinal ischemia. This contribution presents a summary of the anatomic and physiologic fundamentals of mesenterial perfusion, provides an overview of possible causes and pathogenesis of intestinal perfusion disturbances, and describes the typical CT findings of the different types of acute intestinal ischemia. Also discussed are possible pitfalls, which can be responsible for both false negative and false positive diagnoses. (orig.)