Computed tomography appearance of an intra-aortic balloon pump - A potential pitfall in diagnosis

The case of a patient with an indwelling intra-aortic balloon pump (IABP) who underwent computed tomography (CT) to rule out mesenteric ischemia is reported. Three-dimensional reconstruction revealed regularly spaced air-fluid levels within the aorta. Intra-aortic balloon pump function is reviewed, and it is shown that its artifactual appearance on CT results from the phase difference between the cardiac cycle and gantry speed. Recognizing and understanding the appearance of an IABP is important so as not confuse it with intra-aortic air, which suggests ischemia.