Polo mint sign of portal vein thrombosis

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Vague, persistent crampy abdominal pain.

Patient Data

Age: 45 years
Gender: Male

The left hepatic, portal, splenic and superior mesenteric veins contain large volume thrombus. The portal vein, has large central thrombus with a rim of surrounding luminal contrast, in keeping with the 'Polo Mint' sign.

Variable attenuation of the liver, due to the venous thrombus and thick-walled jejunum in the left side of the abdomen, likely due to venous congestion, secondary to the superior mesenteric vein thrombosis.

Polo mints. 

Annotated image

"Polo Mint" sign. 

Case Discussion

Although originally described on CTPA with a pulmonary embolus, the 'Polo mint' sign, can refer to any venous thrombosis on CT where a thin rim of contrast (white like a Polo mint) is around the central thrombus.  The forms the configuration of the popular confectionary the Polo mint.

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