Hypoperfusion Complex

  • Etiology: trauma causing shock, is reperfusion injury to gut following hypotension and intestinal ischemia
  • Imaging: diffuse intestinal dilation with fluid filled loops, intense enhancement of bowel walls / mesentery / adrenals / kidneys / pancreas, decreased caliber of inferior vena cava and aorta, free fluid
  • Clinical: marker of hypovolemic shock, very poor prognosis – 85% die within 72 hours

Cases of Hypoperfusion Complex

Axial CT with contrast of the abdomen shows diffusely dilated intensely enhancing loops of small bowel. The aorta and inferior vena cava are very narrow in caliber. There is a hematoma in the right-sided subcutaneous tissues
CT of hypoperfusion complex / shock bowel in child abuse
Axial CT with contrast of the abdomen shows periportal edema in the liver, diffusely dilated and hyperenhancing loops of small bowel and a narrow caliber inferior vena cava.