Post-ischemic bowel stricture: CT features in eight cases

Jin Sil Kim, Hyun Jin Kim, Seung Mo Hong, Seong Ho Park, Jong Seok Lee, Ah Young Kim, Hyun Kwon Ha

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

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.

Original languageEnglish
Pages (from-to)936-945
Number of pages10
JournalKorean Journal of Radiology
Volume18
Issue number6
DOIs
StatePublished - 1 Nov 2017

Bibliographical note

Publisher Copyright:
© 2017 The Korean Society of Radiology.

Keywords

  • Bowel ischemia
  • Bowel stricture
  • CT
  • Ischemic stricture
  • Stenosis

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