Confused doppler u/s of sma: based on the velocities pre and postprandial there is evidence of significant stenosis greater than 70% at the level of the sma proximally. but ct shows sma axis is patent??? how is that possible? next step?

Evaluating SMA: CT scan great overall study and can reveal bowel wall thickening and causes of ischemia. Infectious or autoimmune colitis (Ulcerative colitis) can mimic mesenteric ischemia. Pre and postprandial doppler ultrasound are effective in evaluating mesenteric flow after a meal but studies show it is not good at detecting venous causes of obstruction. MRI and angiography likely next steps. Good luck.

Was the CT: a CT Angiogram or just a standard abdomen CT? If the latter, it might be difficult to assess a SMA stenosis. In any cases, stenosis means narrowing, not necessarily occlusion. So, a vessel that is 70% stenotic means that the lumen diameter is 70% narrowed, but by definition it is still patent.