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Updated: May 18, 2026
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Multidetector CT features of mesenteric vein thrombosis
Rafael Duran1, Alban L Denys, Igor Letovanec
1Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, 1011 Lausanne, Switzerland.
Abstract:
Mesenteric vein thrombosis (MVT) accounts for 5%-15% of all mesenteric ischemic events and is classified as either primary or secondary. Primary MVT is idiopathic, whereas secondary MVT can result from a variety of underlying diseases and risk factors, including primary hypercoagulable states or prothrombotic disorders, myeloproliferative neoplasms, cancer (most frequently of the pancreas or liver), diverse inflammatory conditions, recent surgery, portal hypertension, and miscellaneous causes such as oral contraceptives or pregnancy. Clinical symptoms of MVT are rather nonspecific and are mainly characterized by abdominal pain. The mortality rate for MVT remains high, since even now the diagnosis is often delayed. Multidetector computed tomography (CT) is the modality of choice in this context. Although venous bowel ischemia occurs only infrequently with MVT, radiologists should be familiar with its multidetector CT features. Familiarity with the possible causes of MVT, the underlying pathogenic mechanisms associated with MVT, and the correlation between multidetector CT features and these pathogenic mechanisms is necessary to optimize medical management and improve patient care.
Insights
Mesenteric vein thrombosis (MVT) is a serious condition often diagnosed late, leading to high mortality. Early diagnosis using multidetector computed tomography (CT) is crucial for better patient outcomes.
Area of Science:
- Radiology
- Vascular Surgery
- Gastroenterology
Background:
- Mesenteric vein thrombosis (MVT) comprises 5%-15% of mesenteric ischemic events.
- It is categorized as primary (idiopathic) or secondary, linked to hypercoagulable states, cancer, inflammation, surgery, and other factors.
- Nonspecific symptoms, primarily abdominal pain, often delay diagnosis, contributing to high MVT mortality rates.
Purpose of the Study:
- To highlight the importance of multidetector computed tomography (CT) in diagnosing MVT.
- To emphasize the need for radiologists to understand MVT causes, pathogenic mechanisms, and CT features.
- To improve medical management and patient care for MVT.
Main Methods:
- Review of existing literature on MVT.
- Analysis of multidetector CT features associated with MVT.
- Correlation of CT findings with underlying causes and pathogenic mechanisms.
Main Results:
- Multidetector CT is the preferred imaging modality for MVT diagnosis.
- Venous bowel ischemia is an infrequent but serious complication of MVT.
- Understanding the link between CT findings and MVT causes aids in management.
Conclusions:
- Early diagnosis of MVT via multidetector CT is critical.
- Radiologists must be adept at recognizing MVT and its potential complications on CT.
- Improved understanding of MVT pathophysiology and imaging correlates can enhance patient care and outcomes.
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