Acute mesenteric ischemia is a life-threatening condition with high mortality. Acute mesenteric ischemia is responsible for fewer than one in 1000 hospital admissions, but its mortality rate ranges between 30% and 90% . Acute mesenteric ischemia is most commonly secondary to embolism followed by arterial thrombosis, non-occlusive ischemia, and less commonly venous thrombosis . Delay in diagnosis contributes to the continued high mortality rate. Early diagnosis and prompt effective treatment are essential to Correspondence to improve clinical outcomes

However, Acute mesenteric ischemia represents a major diagnostic challenge because of its varied presentations and multiple causes . Patients usually present with non-specific abdominal symptoms and laboratory findings, which leads to delayed diagnoses . Therefore, diagnostic imaging has emerged as one of the most crucial components in the diagnostic work-up of suspected

Recent technical advances have made computed tomography angiography the modality of choice in the setting of suspected Acute mesenteric ischemia.computed tomography angiography is a rapid and non-invasive diagnostic tool for assessing intestinal vasculature and bowel . computed tomography angiography allows early diagnosis and differentiation between occlusive and non-occlusive causes, which is important to direct therapeutic approach . Overall, combining vascular and bowel assessment results in a high diagnostic accuracy . A recent meta-analysis showed a sensitivity of 93% and a specificity of 96% . However, this meta analysis also showed that the prevalence of confirmed .Acute mesenteric ischemia is less than 25% among the patients referred to computed tomography angiograph in the setting of suspected Acute mesenteric ischemia .Knowledge of the prevalence and the demographic distribution of alternative diagnoses in the remaining three-fourths of patients without Acute mesenteric ischemia is important for appropriate patient care. computed tomography angiograph is considered to allow for a variety of acute alternative diagnoses, ensuring timely triage of these patients.

Inclusion Criteria:

Clinically suspected acute mesenteric ischemia based on physician evaluation Patients should be evaluated during 48 h of acute presentation

Exclusion Criteria:

• Renal Impairment
• Known allergy to iodine contrast media.

Clinically suspected acute mesentric ischemia based on physician evaluation Patients should be evaluated during 48 h of acute presentation