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Post-ischemic bowel stricture: CT features in eight cases

Title
Post-ischemic bowel stricture: CT features in eight cases
Authors
Kim J.S.Kim H.J.Hong S.-M.Park S.H.Lee J.S.Kim A.Y.Ha H.K.
Ewha Authors
김진실
Issue Date
2017
Journal Title
Korean Journal of Radiology
ISSN
1229-6929JCR Link
Citation
vol. 18, no. 6, pp. 936 - 945
Keywords
Bowel ischemiaBowel strictureCTIschemic strictureStenosis
Publisher
Korean Radiological Society
Indexed
SCIE; SCOPUS; KCI WOS scopus
Abstract
Objective: To investigate the characteristic radiologic features of post-ischemic stricture, which can then be implemented to differentiate that specific disease from other similar bowel diseases, with an emphasis on computed tomography (CT) features. Materials and Methods: Eight patients with a diagnosis of ischemic bowel disease, who were also diagnosed with post-ischemic stricture on the basis of clinical or pathologic findings, were included. Detailed clinical data was collected from the available electronic medical records. Two radiologists retrospectively reviewed all CT images. Pathologic findings were also analyzed. Results: The mean interval between the diagnosis of ischemic bowel disease and stricture formation was 57 days. The severity of ischemic bowel disease was variable. Most post-ischemic strictures developed in the ileum (n = 5), followed by the colon (n = 2) and then the jejunum (n = 1). All colonic strictures developed in the “watershed zone.” The pathologic features of post-ischemic stricture were deep ulceration, submucosal/subserosal fibrosis and chronic transmural inflammation. The mean length of the post-ischemic stricture was 7.4 cm. All patients in this study possessed one single stricture. On contrast-enhanced CT, most strictures possessed concentric wall thickening (87.5%), with moderate enhancement (87.5%), mucosal enhancement (50%), or higher enhancement in portal phase than arterial phase (66.7%). Conclusion: Post-ischemic strictures develop in the ileum, jejunum and colon after an interval of several weeks. In the colonic segment, strictures mainly occur in the “watershed zone.” Typical CT findings include a single area of concentric wall thickening of medium length (mean, 7.4 cm), with moderate and higher enhancement in portal phase and vasa recta prominence. © 2017 The Korean Society of Radiology.
DOI
10.3348/kjr.2017.18.6.936
Appears in Collections:
의료원 > 의료원 > Journal papers
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