ArticleRadiology case reports2026
Non-occlusive mesenteric ischemia secondary to diabetic ketoacidosis in a patient receiving olanzapine: A case report.
Article in Radiology case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Non-occlusive mesenteric ischemia is a life-threatening condition caused by mesenteric vasoconstriction without arterial occlusion. Early diagnosis remains challenging because of nonspecific clinical symptoms. Here, we report a case of non-occlusive mesenteric ischemia associated with a hyperglycemic crisis in a patient treated with olanzapine. A 29-year-old man presented with altered mental status, abdominal pain, and diarrhea. Laboratory assessment revealed severe hyperglycemia, ketosis, dehydration, and acute kidney injury. Non-contrast abdominal computed tomography (CT) demonstrated pneumatosis intestinalis. After four days, follow-up contrast-enhanced CT revealed diffuse lack of bowel wall enhancement consistent with severe bowel ischemia. No occlusive lesion of the superior mesenteric artery was identified. The patient was diagnosed with non-occlusive mesenteric ischemia based on imaging findings and systemic hypoperfusion due to diabetic ketoacidosis. This case highlights the limitations of non-contrast CT in suspected bowel ischemia and the importance of early contrast-enhanced CT, even in patients with renal dysfunction, because delayed diagnosis may lead to irreversible bowel necrosis.
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