CTICasesLow-Positioned Intra-Aortic Balloon Pump causing Mesenteric Ischemia
Imaging findings
CT angiogram of the abdomen and pelvis shows the distal balloon tip of an intra-aortic balloon pump (IABP) positioned abnormally low in the abdominal aorta, directly adjacent to the celiac axis and superior mesenteric artery (SMA) origins. Marked, extensive pneumatosis intestinalis is present throughout the loops of the small bowel.
Key takeaways
An abnormally low-positioned IABP can physically obstruct flow into major abdominal aortic branches. In a low cardiac output state, this mechanical obstruction of the celiac and superior mesenteric arteries can lead to catastrophic, fatal mesenteric ischemia and bowel necrosis.
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