Which CT finding is indicative of colonic ischemia?

Colonic wall thickening with fat stranding is a key CT finding indicative of colonic ischemia. This manifestation occurs because ischemia leads to inflammation and edema of the bowel wall. As the blood supply diminishes, the wall becomes engorged, resulting in thickening. Surrounding fat stranding reflects the inflammatory response and edema in the pericolonic fat, which is often present when there is underlying bowel ischemia or inflammation.

Identifying this CT finding is critical in the clinical context, as it suggests the need for either further evaluation or intervention. The presence of colonic wall thickening and fat stranding, especially in a patient with an appropriate clinical history or presenting symptoms, can be a strong indicator of ischemic colitis or mesenteric ischemia.

The other choices, while relevant to gastrointestinal conditions, do not specifically indicate colonic ischemia as pointedly. For instance, colonic wall flattening can suggest other pathological conditions such as obstruction but is not a direct sign of ischemia. An absence of blood flow is more indicative of a vascular event rather than a direct imaging finding. Finally, the presence of perforation is a significant complication of various bowel conditions, including ischemia, but does not specifically indicate the initial ischem