Left Colonic Bleeding Secondary to Inferior Mesenteric Vein Stenosis

Lower gastrointestinal bleeding is most commonly associated with diverticulosis, ischemic colitis, vascular ectasia, and anorectal disease and less commonly associated with colonic malignancy. Infrequently, it is associated with mesenteric varices, a rare etiology that is not well documented in the radiology literature. We present a case of a 50-year-old man diagnosed as having intermittent left colonic bleeding from mesenteric varices due to a critical stenosis at the portal vein-inferior mesenteric vein confluence. This case illustrates a multimodality imaging approach to arrive at the diagnosis with a brief discussion of an atypical endovascular intervention. At the conclusion, we suspect that venous stenting may be suboptimal in treating mesenteric variceal bleeding and recurrence is likely unavoidable.