Plain radiographs such as X-ray abdomen can be helpful in ruling out other important causes of acute abdomen such as perforation. The sensitivity of this test is limited because it can show normal findings in as many as 25% of cases of mesenteric ischemia.

Plain X-rays are often normal or show non-specific findings until bowel infarction has developed. They have limited significance in the diagnosis and treatment of mesenteric ischemia. However, a negative radiograph does not rule out mesenteric ischemia.

Findings shown on X-ray abdomen are:^[1][2]

• Adyanamic ileus
• Bowel wall thickening from submucosal edema or hemorrhage
• Dilated bowel loops
• Pneumatosis in advanced cases of ischemia^[3][4]
• Portal venous gas

• Intestinal perforation when occurs, presents as intraperitoneal air