Skip to main content
Top
Published in: La radiologia medica 1/2015

01-01-2015 | EMERGENCY RADIOLOGY

Nonocclusive mesenteric ischaemia: think about it

Authors: Maria Antonietta Mazzei, Luca Volterrani

Published in: La radiologia medica | Issue 1/2015

Login to get access

Abstract

Nonocclusive mesenteric ischaemia (NOMI) is an acute mesenteric circulatory disorder that is not caused by an organic occlusion of blood vessels. It could involve all the abdominal parenchymas and viscera and the whole gastrointestinal tract (from the oesophagus to the rectum), insomuch that the involvement of the entire colon should be considered a distinctive tract in diagnosing this condition in respect of the occlusive forms of ischaemia. The aim of this article is to review the role of imaging in the diagnosis of NOMI and in particular its CT appearances. Recognition of the characteristic CT appearances and the variations associated with a reperfusion event may help in the accurate interpretation of CT in the diagnosis and management of NOMI.
Literature
1.
go back to reference Trompeter M, Brazda T, Remy CT et al (2002) Non-occlusive mesenteric ischemia: etiology, diagnosis, and interventional therapy. Eur Radiol 12:1179–1187PubMedCrossRef Trompeter M, Brazda T, Remy CT et al (2002) Non-occlusive mesenteric ischemia: etiology, diagnosis, and interventional therapy. Eur Radiol 12:1179–1187PubMedCrossRef
3.
go back to reference Mazzei MA, Guerrini S, Cioffi Squitieri N et al (2014) Non-obstructive mesenteric ischemia after cardiovascular surgery: not so uncommon. Ann Thorac Cardiovsc Surg 20(3):253–255 Mazzei MA, Guerrini S, Cioffi Squitieri N et al (2014) Non-obstructive mesenteric ischemia after cardiovascular surgery: not so uncommon. Ann Thorac Cardiovsc Surg 20(3):253–255
4.
go back to reference Kamimura K, Oosaki A, Sugahara S, Mori S (2008) Survival of three nonocclusive mesenteric ischemia patients following early diagnosis by multidetector row computed tomography and prostaglandin E1 treatment. Intern Med 47:2001–2006PubMedCrossRef Kamimura K, Oosaki A, Sugahara S, Mori S (2008) Survival of three nonocclusive mesenteric ischemia patients following early diagnosis by multidetector row computed tomography and prostaglandin E1 treatment. Intern Med 47:2001–2006PubMedCrossRef
5.
go back to reference Mitsuyoshi A, Obama K, Shinkura N et al (2007) Survival in nonocclusive mesenteric ischemia: early diagnosis by multidetector row computed tomography and early treatment with continuous intravenous high-dose prostaglandin E(1). Ann Surg 246:229–235PubMedCentralPubMedCrossRef Mitsuyoshi A, Obama K, Shinkura N et al (2007) Survival in nonocclusive mesenteric ischemia: early diagnosis by multidetector row computed tomography and early treatment with continuous intravenous high-dose prostaglandin E(1). Ann Surg 246:229–235PubMedCentralPubMedCrossRef
6.
go back to reference Schoots IG, Koffeman GI, Legemate DA et al (2004) Systematic review of survival after acute mesenteric ischaemia according to disease aetiology. Br J Surg 91:17–27PubMedCrossRef Schoots IG, Koffeman GI, Legemate DA et al (2004) Systematic review of survival after acute mesenteric ischaemia according to disease aetiology. Br J Surg 91:17–27PubMedCrossRef
8.
go back to reference Mazzei MA, Guerrini S, Cioffi Squitieri N et al (2012) Diagnosis of acute mesenteric ischemia/infarction in the era of multislice CT. Recenti Prog Med 103:435–437PubMed Mazzei MA, Guerrini S, Cioffi Squitieri N et al (2012) Diagnosis of acute mesenteric ischemia/infarction in the era of multislice CT. Recenti Prog Med 103:435–437PubMed
9.
go back to reference Scaglione M, Grassi R, Pinto A et al (2004) Positive predictive value and negative predictive value of spiral CT in the diagnosis of closed loop obstruction complicated by intestinal ischemia. Radiol Med 107:69–77PubMed Scaglione M, Grassi R, Pinto A et al (2004) Positive predictive value and negative predictive value of spiral CT in the diagnosis of closed loop obstruction complicated by intestinal ischemia. Radiol Med 107:69–77PubMed
10.
go back to reference Bassiounty HS (1997) Nonocclusive mesenteric ischemia. Surg Clin North Am 77:319–326CrossRef Bassiounty HS (1997) Nonocclusive mesenteric ischemia. Surg Clin North Am 77:319–326CrossRef
11.
go back to reference Cerqueira NF, Hussni CA, Yoshida WB (2005) Pathophysiology of mesenteric ischemia/reperfusion: a review. Acta Cir Bras 20:336–343PubMed Cerqueira NF, Hussni CA, Yoshida WB (2005) Pathophysiology of mesenteric ischemia/reperfusion: a review. Acta Cir Bras 20:336–343PubMed
12.
go back to reference Noffsinger A, Fenoglio-Preiser C, Maru D, Gilinsky N (2007) Gastrointestinal diseases. Atlas of nontumor pathology. ARP Press, Washington Noffsinger A, Fenoglio-Preiser C, Maru D, Gilinsky N (2007) Gastrointestinal diseases. Atlas of nontumor pathology. ARP Press, Washington
16.
go back to reference Kazui T, Yamasaki M, Abe K et al (2012) Non-obstructive mesenteric ischemia: a potentially lethal complication after cardiovascular surgery: report of two cases. Ann Thorac Cardiovasc Surg 18:56–60PubMedCrossRef Kazui T, Yamasaki M, Abe K et al (2012) Non-obstructive mesenteric ischemia: a potentially lethal complication after cardiovascular surgery: report of two cases. Ann Thorac Cardiovasc Surg 18:56–60PubMedCrossRef
19.
go back to reference Cakmaz R, Büyükaşık O, Kahramansoy N et al (2013) A combination of plasma DAO and citrulline levels as a potential marker for acute mesenteric ischemia. Libyan J Med 26(8):1–6. doi:10.3402/ljm.v8i0.20596 Cakmaz R, Büyükaşık O, Kahramansoy N et al (2013) A combination of plasma DAO and citrulline levels as a potential marker for acute mesenteric ischemia. Libyan J Med 26(8):1–6. doi:10.​3402/​ljm.​v8i0.​20596
20.
21.
go back to reference Moschetta M, Stabile Ianora AA, Pedote P et al (2009) Prognostic value of multidetector computed tomography in bowel infarction. Radiol Med 114:780–791PubMedCrossRef Moschetta M, Stabile Ianora AA, Pedote P et al (2009) Prognostic value of multidetector computed tomography in bowel infarction. Radiol Med 114:780–791PubMedCrossRef
23.
go back to reference Furukawa A, Kanasaki S, Kono N et al (2009) CT diagnosis of acute mesenteric ischemia from various causes. AJR Am J Roentgenol 192:408–416PubMedCrossRef Furukawa A, Kanasaki S, Kono N et al (2009) CT diagnosis of acute mesenteric ischemia from various causes. AJR Am J Roentgenol 192:408–416PubMedCrossRef
24.
go back to reference Mazzei MA, Mazzei FG, Marrelli D et al (2012) Computed tomographic evaluation of mesentery: diagnostic value in acute mesenteric ischemia. J Comput Assist Tomogr 36:1–7PubMedCrossRef Mazzei MA, Mazzei FG, Marrelli D et al (2012) Computed tomographic evaluation of mesentery: diagnostic value in acute mesenteric ischemia. J Comput Assist Tomogr 36:1–7PubMedCrossRef
25.
go back to reference Grassi R, Di Mizio R, Pinto A et al (2004) Serial plain abdominal film findings in the assessment of acute abdomen: spastic ileus, hypotonic ileus, mechanical ileus and paralytic ileus. Radiol Med 108:56–70PubMed Grassi R, Di Mizio R, Pinto A et al (2004) Serial plain abdominal film findings in the assessment of acute abdomen: spastic ileus, hypotonic ileus, mechanical ileus and paralytic ileus. Radiol Med 108:56–70PubMed
26.
go back to reference Grassi R, Pinto A, Romano L et al (1997) Twenty-six consecutive patients with acute superior mesenteric infarction. Comparison of conventional radiology, ultrasonography, and computerized tomography. Radiol Med 93:699–703PubMed Grassi R, Pinto A, Romano L et al (1997) Twenty-six consecutive patients with acute superior mesenteric infarction. Comparison of conventional radiology, ultrasonography, and computerized tomography. Radiol Med 93:699–703PubMed
27.
go back to reference Siegelman SS, Sprayregen S, Boley SJ (1974) Angiographic diagnosis of mesenteric arterial vasoconstriction. Radiology 112:533–542PubMedCrossRef Siegelman SS, Sprayregen S, Boley SJ (1974) Angiographic diagnosis of mesenteric arterial vasoconstriction. Radiology 112:533–542PubMedCrossRef
28.
go back to reference Boley SJ, Sprayregan S, Siegelman SS, Veith FJ (1977) Initial results from an aggressive roentgenological and surgical approach to acute mesenteric ischemia. Surgery 82:848–855PubMed Boley SJ, Sprayregan S, Siegelman SS, Veith FJ (1977) Initial results from an aggressive roentgenological and surgical approach to acute mesenteric ischemia. Surgery 82:848–855PubMed
29.
go back to reference Woodhams R, Nishimaki H, Fujii K et al (2010) Usefulness of multidetector-row CT (MDCT) for the diagnosis of non-occlusive mesenteric ischemia (NOMI): assessment of morphology and diameter of the superior mesenteric artery (SMA) on multi-planar reconstructed (MPR) images. Eur J Radiol 76:96–102PubMedCrossRef Woodhams R, Nishimaki H, Fujii K et al (2010) Usefulness of multidetector-row CT (MDCT) for the diagnosis of non-occlusive mesenteric ischemia (NOMI): assessment of morphology and diameter of the superior mesenteric artery (SMA) on multi-planar reconstructed (MPR) images. Eur J Radiol 76:96–102PubMedCrossRef
30.
go back to reference Nakamura Y, Urashima M, Toyota N et al (2013) Non-occlusive mesenteric ischemia (NOMI): utility of measuring the diameters of the superior mesenteric artery and superior mesenteric vein at multidetector CT. Jpn J Radiol. (Epub ahead of print) Nakamura Y, Urashima M, Toyota N et al (2013) Non-occlusive mesenteric ischemia (NOMI): utility of measuring the diameters of the superior mesenteric artery and superior mesenteric vein at multidetector CT. Jpn J Radiol. (Epub ahead of print)
32.
go back to reference Lassandro F, di Santo Stefano ML, Maria Porto A, Grassi R, Scaglione M, Rotondo A (2010) Intestinal pneumatosis in adults: diagnostic and prognostic value. Emerg Radiol. (Epub ahead of print) Lassandro F, di Santo Stefano ML, Maria Porto A, Grassi R, Scaglione M, Rotondo A (2010) Intestinal pneumatosis in adults: diagnostic and prognostic value. Emerg Radiol. (Epub ahead of print)
34.
go back to reference Balthazar EJ, Yen BC, Gordon RB (1999) Ischemic colitis: CT evaluation of 54 cases. Radiology 211:381–388PubMedCrossRef Balthazar EJ, Yen BC, Gordon RB (1999) Ischemic colitis: CT evaluation of 54 cases. Radiology 211:381–388PubMedCrossRef
37.
go back to reference Berritto D, Somma F, Landi N et al (2011) Seven-Tesla micro-MRI in early detection of acute arterial ischaemia: evolution of findings in an in vivo rat model. Radiol Med 116:829–841PubMedCrossRef Berritto D, Somma F, Landi N et al (2011) Seven-Tesla micro-MRI in early detection of acute arterial ischaemia: evolution of findings in an in vivo rat model. Radiol Med 116:829–841PubMedCrossRef
38.
go back to reference Romano S, Scaglione M, Gatta G et al (2004) Association of splenic and renal infarctions in acute abdominal emergencies. Eur J Radiol 50:48–58PubMedCrossRef Romano S, Scaglione M, Gatta G et al (2004) Association of splenic and renal infarctions in acute abdominal emergencies. Eur J Radiol 50:48–58PubMedCrossRef
39.
go back to reference Lassandro F, Scaglione M, Rossi G et al (2002) Portomesenteric vein gas: diagnostic and prognostic value. Emerg Radiol 9:96–99PubMedCrossRef Lassandro F, Scaglione M, Rossi G et al (2002) Portomesenteric vein gas: diagnostic and prognostic value. Emerg Radiol 9:96–99PubMedCrossRef
40.
go back to reference Moschetta M, Telegrafo M, Rella L et al (2014) Multi-detector CT features of acute intestinal ischemia and their prognostic correlations. World J Radiol 6:130–138PubMedCentralPubMedCrossRef Moschetta M, Telegrafo M, Rella L et al (2014) Multi-detector CT features of acute intestinal ischemia and their prognostic correlations. World J Radiol 6:130–138PubMedCentralPubMedCrossRef
Metadata
Title
Nonocclusive mesenteric ischaemia: think about it
Authors
Maria Antonietta Mazzei
Luca Volterrani
Publication date
01-01-2015
Publisher
Springer Milan
Published in
La radiologia medica / Issue 1/2015
Print ISSN: 0033-8362
Electronic ISSN: 1826-6983
DOI
https://doi.org/10.1007/s11547-014-0460-6

Other articles of this Issue 1/2015

La radiologia medica 1/2015 Go to the issue

EMERGENCY RADIOLOGY

Emergency radiology