Computed tomography findings of mesenteric ischemia related to acute superior mesenteric vein thrombosis: A case report

Abstract

Acute mesenteric ischemia (AMI) is a condition caused by a decrease in blood flow due to occlusion of the mesenteric vessels, vasospasm or hypoperfusion. Approximately 5-15% of all AMI are related to mesenteric venous thrombosis (MVT). MVT has high mortality rate despite of advanced medical technologies. Thus, early diagnosis is crucial in the prognosis of the disease. Contrast-enhanced computed tomography (CT) and CT angiography are the most helpful radiological examinations for early diagnosis. We present the case of 55 years old patient with AMI accompanied by radiological images. Our patient was admitted to hospital with severe abdominal pain persistent since a week. The patient had upper gastro-intestinal system (GIS) bleeding history due to peptic ulcer a month ago. In the CT imaging, we found thrombosis along superior mesenteric vein up to distal portal junction. There was pneumatosis intestinalis as a consequence of necrosis, ileal walls were concentric, thick and hypodense because of edema. Total intestinal segments were dilated with air-fluid levels. Ileus was present without obstruction. The findings support the diagnosis of AMI due to MVT.