CTICasesProfound Hypovolemic Shock with Shock Bowel
Imaging findings
CT images demonstrate marked compression and flattening of the inferior vena cava and left atrium, indicating severe hypovolemia. The aorta is partially collapsed and flattened, particularly at the level of the diaphragmatic hiatus. Severe hypoperfusion is evidenced by a small and poorly enhancing celiac axis and superior mesenteric artery, accompanied by bowel wall thickening, mucosal hyper-enhancement, and poor renal parenchymal enhancement with loss of corticomedullary differentiation.
Key takeaways
Radiologic signs of profound shock (such as hypovolemic or septic shock) include flattening of the inferior vena cava and left atrium, along with partial collapse of the aorta at the diaphragmatic hiatus. These central vascular findings are accompanied by signs of systemic hypoperfusion, such as shock bowel (characterized by hyper-enhancing, thickened bowel loops) and diminished parenchymal organ perfusion.
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