ROENTGENOGRAPHIC ASPECTS OF INTESTINAL ISCHEMIA

Until recent years, the general concept of vascular disease involving the intestine was of overwhelming infarction leading to rapid death unless corrected surgically. While this type of involvement may occur, there has been increasing recognition of a whole spectrum of intestinal ischemic states. Some are mild and chronic. Longstanding symptoms such as abdominal pain, weight loss, disturbed intestinal peristalsis, malabsorption, or fatty diarrhea may be the result of ischemic intestinal abnormality.

The possibility of a vascular abnormality as a cause for such complaints should be more promptly recognized by clinicians and by radiologists. Plain roentgenograms and contrast studies of the bowel may be interpreted with greater understanding and discrimination if the patterns produced by ischemia are more widely recognized.

Arteriography then gives the diagnostic roentgenologist a very accurate method of identifying the presence of vascular disease, of localizing with precision, and studying the pattern of abnormal vascular flow. The ability to obtain this information about visceral vessels is of much more than academic interest. It permits prompt decision as to whether medical or surgical management is required and provides the vascular surgeon with the anatomic detail he needs ahead of time.

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