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Mesenteric vein thrombosis: CT identification.

A Rosen, M Korobkin, P M Silverman

    AJR. American Journal of Roentgenology
    |July 1, 1984
    PubMed
    Summary
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    Computed tomography (CT) scans revealed a distinct pattern for superior mesenteric vein thrombosis (SMVT). This imaging finding, a dense vein wall around a central clot, aids in diagnosing SMVT.

    Area of Science:

    • Radiology
    • Vascular Surgery
    • Gastroenterology

    Background:

    • Superior mesenteric vein thrombosis (SMVT) is a rare but serious condition.
    • Accurate and timely diagnosis is crucial for patient outcomes.
    • Computed tomography (CT) is a key imaging modality for abdominal vascular assessment.

    Purpose of the Study:

    • To define the characteristic computed tomographic (CT) appearance of superior mesenteric vein thrombosis (SMVT).
    • To correlate CT findings with clinical presentation and other diagnostic methods.

    Main Methods:

    • Retrospective review of six patients with diagnosed superior mesenteric vein thrombosis (SMVT).
    • Analysis of contrast-enhanced computed tomographic (CT) scans for specific venous wall and intraluminal characteristics.

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  • Correlation of CT findings with angiography and surgical confirmations where available.
  • Assessment of clinical symptoms, particularly acute ischemic bowel disease.

    • Main Results:

    • All six patients exhibited a high-density superior mesenteric vein wall surrounding a central filling defect on contrast-enhanced CT scans.
    • Four patients had isolated SMVT; one had concurrent portal and splenic vein thrombosis; another had concurrent portal vein and inferior vena cava thrombosis.
    • Diagnosis was confirmed by angiography in two patients and surgery in one.
    • Only one patient presented with acute ischemic bowel disease; the other five were asymptomatic for acute ischemia.

    Conclusions:

    • Contrast-enhanced CT demonstrates a characteristic appearance of superior mesenteric vein thrombosis (SMVT) with a dense venous wall and central clot.
    • This imaging pattern can aid in the diagnosis of SMVT, even in the absence of acute ischemic bowel symptoms.
    • Further investigation with angiography or surgery may be necessary for definitive confirmation.