Patients with embolic IMA occlusion in acute phase: left colonic wall thickening (white arrow) with evidence of “little rose” sign or target aspect after i.v. contrast medium administration was detected; pericolic fluid was also present (curved arrow); the endoscopy showed edematous and thickened mucosa with diffuse petechial hemorrhage and hemorrhagic nodules; in some segments also hemorrhagic ulcerations were detected. These findings were histologically related to vascular congestion with intraparietal haemorrhage and increased cellularity with the presence of reactive inflammatory cells.