PMC5305076_01
Abdominal ultrasound: circumferential thickening of the small bowel wall (A), maximum thickness 7.5 mm (B), length 6.6 cm (C)
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Contrast-enhanced CT scan of abdomen and pelvis: A - the thickening of jejunal walls; B - dissection fold of SMA, axial section; C - dissection fold of SMA, sagittal section; D - thrombosis of the ileo-colic and jejunal arterial branches of SMA; E - vascular reconstruction, the right branch of SMA is missing.
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CT scan confirmed the small bowel circumferential thickening with no free fluid or gas and a normal appendix. CT scan also showed a dissection of the SMA starting at approximately 1.8 cm from root and extending to the origin of the first branches; three of the jejuno-ileal branches and the right colic arteries had a contrast filling defect and were slightly dilated suggesting the presence of intraluminal thrombosis (Figure 2).
CTA of abdomen and pelvis with vascular reconstruction: the right branch of SMA without contrast-enhanced.
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A month later CT angiography (CTA) was performed showing a permeable SMA until bifurcation with a non-permeable right branch (Fig 3).