Figure 10. Chronic mesenteric ischemia in a 68-year-old woman with the classic symptoms of the disease. Multi-detector row CT scan demonstrates atherosclerotic plaque and minimal narrowing at the origins of the celiac axis (straight arrow) and SMA (curved arrow), which otherwise appear normal. The small bowel and colon (not shown) demonstrated normal enhancement with no evidence of thickening. Because of the CT findings and clinical symptoms, the patient underwent aortomesenteric bypass surgery. Although the CT findings may be subtle, they may also be hemodynamically significant, especially in situations that put stress on the mesenteric circulation (eg, after meals).