Radiological Evaluation of Bowel Ischemia

Radiol Clin North Am. 2015 Nov;53(6):1241-54. doi: 10.1016/j.rcl.2015.06.009.


Intestinal ischemia, which refers to insufficient blood flow to the bowel, is a potentially catastrophic entity that may require emergent intervention or surgery in the acute setting. Although the clinical signs and symptoms of intestinal ischemia are nonspecific, computed tomography (CT) findings can be highly suggestive in the correct clinical setting. In our article, we review the CT diagnosis of arterial, venous, and nonocclusive intestinal ischemia. We discuss the vascular anatomy, pathophysiology of intestinal ischemia, CT techniques for optimal imaging, key and ancillary radiological findings, and differential diagnosis.

Keywords: Bowel infarction; Bowel ischemia; Computed tomography; Intestinal ischemia; Mesenteric artery occlusion; Mesenteric ischemia; Oral contrast; Pneumatosis intestinalis.

Publication types

  • Review

MeSH terms

  • Contrast Media
  • Humans
  • Intestinal Diseases / diagnostic imaging
  • Intestines / blood supply*
  • Intestines / diagnostic imaging*
  • Ischemia / diagnostic imaging
  • Mesenteric Ischemia / diagnostic imaging*
  • Radiographic Image Enhancement
  • Tomography, X-Ray Computed*
  • Vascular Diseases / diagnostic imaging


  • Contrast Media