Intestinal Adhesions: CT Imaging Characteristics and Diagnostic Insights

Under normal circumstances, layers of fat separate the intestinal walls. When this fat disappears due to inflammation or injury, the intestines may adhere to each other or to surrounding tissues, resulting in a condition known as intestinal adhesion. These adhesions can cause the intestines to clump together, a feature that is clearly visible on CT scans as a tangled mass of bowel loops.

CT Features of Intestinal Adhesions

One of the key signs of intestinal adhesions on CT imaging is the loss of normal fat planes between segments of the intestine. This often appears as a convergence of bowel loops without clear separation. In cases where there is fluid or blood accumulation in the abdominal cavity, irritation of the peritoneum can lead to chronic inflammation and subsequent adhesion formation.

Potential Complications and Imaging Signs

If adhesions become severe, they can cause bowel obstruction. On CT scans, this typically presents with significant dilation of the bowel upstream from the blockage. Radiologists often look for this telltale sign when diagnosing obstructive complications related to adhesions.

Enhancement Patterns in Inflamed Bowel Walls

When inflammation is present in the adhered bowel segments, contrast-enhanced CT scans can reveal important diagnostic clues. These include thickening of the intestinal wall and increased enhancement or "hyperenhancement" along the affected areas, indicating active inflammation or ischemia.

Importance of Accurate Diagnosis

Recognizing these CT findings is crucial for timely diagnosis and management of intestinal adhesions. Since these conditions can lead to serious complications like bowel obstruction, understanding their imaging characteristics helps guide treatment decisions and improves patient outcomes.