Nonocclusive ischemic colitis in a 12-year-old girl: value of unenhanced spiral computed tomography.

A 12-year-old girl was hit by a car and arrived in the emergency room in hemorrhagic shock. Contrast-enhanced computed tomography of the abdomen showed traumatic rupture of the liver and large amounts of intraperitoneal hemorrhage. Unenhanced computed tomography showed a hyperdense thickening of the wall of the descending colon. This finding was consistent with a nonocclusive ischemic colitis, which was confirmed some days later by endoscopy, at a time when the patient had already developed Gram-negative bacteremia. We discuss the pathogenesis of nonocclusive ischemic colitis, computed tomography findings, and the value of unenhanced computed tomography.