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Contrast-enhanced computed tomography (CT) scan. a The dilated small bowel is seen (arrowhead) in the axial postcontrasted CT image, but pneumatosis intestinalis or venous gas is not demonstrated. b Coronal reconstructed CT image shows no thrombus in the superior mesenteric artery (arrowhead).
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There were also no findings of bowel necrosis, such as pneumatosis intestinalis or venous gas (Fig. 1a, b).
Intraoperative indocyanine green fluorescence imaging. a Fluorescence is observed in the bowel, in which blood flow is normal. b The jejunum, measuring 40 cm in length, reveals poor fluorescence visualized as skipped dark spots.
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The small bowel wall, measuring 40 cm in length, showed poor fluorescence emission, indicating ischemia (Fig. 2a, b).
Resected specimen. a Macroscopically, various degrees of ischemic changes (arrowhead) are observed in the mucosa. b Mucosal atrophy (white arrow) with a high degree of hemorrhage (arrowhead) in the submucosa is shown, but transmural necrosis is not observed histopathologically. c A thrombus is not observed in the mesenteric vessels (black arrow).
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The histopathological examination showed various degrees of ischemic change in the bowel wall and mucosal necrosis (Fig. 3a-c).