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DOI:10.2214/AJR.09.2372
AJR 2009; 193:1439-1445
© American Roentgen Ray Society

Pictorial Essay

MDCT Angiography of Mesenteric Bypass Surgery for the Treatment of Chronic Mesenteric Ischemia

Jorge E. Lopera1, Clayton K. Trimmer2, Ramit Lamba3, Rajeev Suri1, Marco A. Cura1, Fadi M. El-Merhi1 and Ghazwan Kroma1

1 Department of Radiology, UT Health Science Center, San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78229.
2 Department of Radiology, UT Southwestern Medical Center, Dallas, Dallas, TX.
3 Department of Radiology, University of California Davis Medical Center, Davis, CA.

OBJECTIVE. Chronic mesenteric ischemia (CMI) is a serious condition that requires surgical or endovascular intervention. Surgical revascularization for the treatment of CMI uses different operative techniques including endarterectomy, vessel reimplantation, and mesenteric bypass. A basic understanding of the operative techniques is essential for the adequate interpretation of imaging studies in patients who have undergone surgery for CMI. In this article, we review the different operative techniques used in the treatment of CMI, discuss the results of surgical intervention for CMI, and illustrate how MDCT angiography (MDCTA) can be used for follow-up and for the detection of early and late complications after surgery.

CONCLUSION. MDCTA is a powerful tool for the postoperative evaluation of patients with CMI. Early detection of graft dysfunction is critical to prevent graft occlusion and the development of potentially fatal mesenteric ischemia. MDCTA can detect early and late complications after surgery and guide additional surgical or endovascular interventions.

Keywords: mesenteric bypass • mesenteric ischemia • MDCT • MDCT angiography


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