Presentation
Abdominal pain
Patient Data
There is thickening of the rectal wall with presacral stranding suggestive of proctitis.
Dilatation and tortuosity of the pararectal veins.
The enlarged tubular structure with solid components and surrounding fat inflammation in the inferior mesenteric vein's expected location drains from the rectal venous plexus to the portal vein.
Filling defect in keeping with thrombus projecting into the portal vein lumen at the site of inferior mesenteric vein termination.
Case Discussion
CT findings show the extension of the inflammatory process from the rectum/perirectal region along the inferior mesenteric vein to the level of the portal vein. Complete thrombosis of the inferior mesenteric vein with perivenous inflammatory changes is compatible with septic thrombophlebitis (pylephlebitis).
Thrombophlebitis of the inferior mesenteric vein is an uncommon condition and is usually associated with sigmoid diverticulitis. The complications consist of hepatic abscess, bowel ischemia, sepsis and septic shock.
Unable to process the form. Check for errors and try again.