Mesenteric angiodysplasia: CT findings. ... approach, with converging input from the internist, gastroenterologist, radiologist, and surgeon.HomeAdvancedSearchTeachingCasesQuizzesFAQsContactUsHistorySubmitaCaseAboutUsHomeAdvancedSearchCase7503CASE7503Publishedon28.04.20090Mesentericangiodysplasia:CTfindings.SectionAbdominalimagingCaseTypeClinicalCasesAuthorsAngeliS,CiniL,FaggioniL,NeriE,CaramellaD,BartolozziC.ConnectedauthorsLorenzoFaggioniPatient71years,femaleDownloadasPDFPrintShowrelatedcasesNotifyadminClinicalHistoryA71-year-oldwomanwithsevereanemiapresentedtoourDepartment.ImagingFindingsA71-year-oldpatientcametoourattentionduesevereanaemia.Faecaloccultbloodtest,opticalcolonoscopy,andoesophagogastroduodenoscopywerenegative,andultrasoundexaminationoftheabdomenwasinconclusiveduetomarkedmeteoricabdominaldistension.Therefore,thepatientunderwentamultidetectorCTexaminationofthesmallbowelacquiredafteroraladministrationof2Lofisosmolarsolution(polyethilenglycole)andintravenousinjectionofanantispasmodicagent(N-butylhyoscinebromide)astomaximizelumendistensionandimprovewall-to-lumencontrast.Imagesobtainedbeforeintravenousadministrationofiodinatedcontrastmaterialshowednoevidentalterationsofthebowelwall,whileoncontrast-enhancedimagesobtainedinthevenousphase(approximately70secondsfollowingstartofcontrastmediuminjection),ecstaticveinscouldbeseeninsidethewallofsomesmallbowelloopslocalizedintheleftiliacfossa,suggestingthediagnosisofsmallbowelangiodysplasia(AD).Thishypothesiswassupportedbythefindingofanecstaticdrainingbranchofthesuperiormesentericvein,asdisplayedonmultiplanarreformation(MPR),maximumintensityprojection(MIP),andvolumerendering(VR)views.Thediagnosiswasconfirmedsurgically.DiscussionObscuregastrointestinal(GI)bleedingisarelativelycommonproblemfacinginternists,gastroenterologists,andsurgeonsinausualclinicalpractice.Itsaetiologyisoccasionallysuggestedbypatient'sage,history,andmedications.Smallbowelhaemorrhageisresponsibleforapproximately4%ofallcasesofgastrointestinalbleed