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BioMed Research International
Volume 2014 (2014), Article ID 895248, 7 pages
http://dx.doi.org/10.1155/2014/895248
Clinical Study

CT Findings in Acute, Subacute, and Chronic Ischemic Colitis: Suggestions for Diagnosis

1Department of Radiology, Second University of Naples, Piazza Miraglia 2, 80138 Napoli, Italy
2Department of Radiology, Stanford University School of Medicine, 300 Pasteur Drive, Room S-072, Stanford, CA 94305-5105, USA
3Emergency Department, “A. Cardarelli” Hospital, Via A. Cardarelli 9, 80131 Napoli, Italy
4Department of Medical, Surgical and Neuro Sciences, Section of Radiological Sciences, University of Siena, Viale Bracci 10, 53100 Siena, Italy

Received 19 June 2014; Accepted 12 August 2014; Published 27 August 2014

Academic Editor: Giovanni Corso

Copyright © 2014 Francesca Iacobellis et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. This paper aims at evaluating CT findings of occlusive and nonocclusive ischemic colitis (IC), in correlation with the etiology and the different phases of the disease. Materials and Methods. CT examination and clinical history of 32 patients with proven IC were retrospectively reviewed. The CT findings were analyzed according to the different phases of the disease (acute, subacute, and chronic). Results. Among the 32 CT examinations performed in the acute phase, 62.5% did not present signs of occlusion of the superior mesenteric artery (SMA) or inferior mesenteric artery (IMA), whereas IMA occlusion was detected in 37.5% of CT examinations. In the acute phase, the presence of pericolic fluid was found in 100% of patients undergoing progressive resorption from acute to subacute phase if an effective reperfusion occurred; the bowel wall thickening was observed in 28.1% patients in acute phase and in 86.4% patients evaluated in subacute phase. The unthickened colonic wall was found in all conditions where ischemia was not followed by effective reperfusion (71.9% of cases), and it was never found in chronic phase, when the colon appeared irregularly thickened. Conclusion. CT allows determining the morphofunctional alterations associated with the IC discriminating the occlusive forms from the nonocclusive forms. CT, furthermore, allows estimating the timing of ischemic damage.