73 year-old female of atrial fibrillation and paralytic ileus. CT scan shows acute superior mesenteric artery occlusion (white arrow) with diminished enhancement of thin bowel walls (white arrowheads) as compared to normal duodenum (black arrowhead). Note normal SMV enhancement (black arrow) and ratio of SMV to SMA diameters of about 1. Extensive bowel gangrene was found at exploratory laparotomy. Bowel resection was not possible and she died of sepsis and acidosis. SMA = superior mesenteric artery, SMV = superior mesenteric vein