Differentiation of shock bowel from traumatic bowel
injury and bowel ischemia is also an essential consideration
for the radiologist. Key differences on imaging present in
bowel trauma include focal rather than diffuse abnormalities;
a lack of intense mucosal enhancement; and signs of severe
structural injury, such as hematomas, perforation, or active
extravasation of contrast [13]. Differentiating shock bowel
from bowel ischemia is a more difficult task because the two
can present similarly on imaging. Bowel wall thickening and
lumen distention may often be present in cases of mesenteric
ischemia (Figure 9, C and D), but mucosal and submucosal
attenuation patterns are more variable.