Sigmoid diverticulitis with inferior mesenteric vein fistula

Multi-slice CT for diagnosis of acute mesenteric ischemia

Acute mesenteric ischemia (AMI) has an acute onset and a high mortality rate with nonspecific clinical presentation and is difficult to diagnose. In recent years, due to fast submillimeter scanning and subtle three-dimensional reconstruction, 64-row multi-slice CT can distinctly demonstrate the stenosis and occlusion of the mesenteric vessels, assess the alteration of morphology and blood perfusion of the intestinal wall and mesentery, and promptly and accurately diagnose AMI, intestinal infarction and its etiology. Therefore, CT has become the most valuable and first-line diagnostic modality for evaluating patients with suspected AMI. AMI has different and complicated CT findings due to different etiology, pathology, extent, position, as well as with or without mural hemorrhage or infection. In this article, we systematically review the multi-slice CT manifestations of AMI and its diagnostic value in various causes of AMI in different stages.

Acute colonic diverticulitis: an update on clinical classification and management with MDCT correlation

Currently, the most commonly used classification of acute colonic diverticulitis (ACD) is the modified Hinchey classification, which corresponds to a slightly more complex classification by comparison with the original description. This modified classification allows to categorize patients with ACD into four major categories (I, II, III, IV) and two additional subcategories (Ia and Ib), depending on the severity of the disease. Several studies have clearly demonstrated the impact of this classification for determining the best therapeutic approach and predicting perioperative complications for patients who need surgery. This review provides an update on the classification of ACD along with a special emphasis on the corresponding MDCT features of the different categories and subcategories. This modified Hinchey classification should be known by emergency physicians, radiologists, and surgeons in order to improve patient care and management because each category has a specific therapeutic approach.