Presentation
Abdominal pain, guarded, frim, and distended.
Patient Data
Multiple loops of mid and distal ilium are markedly edematous and show reduced contrast enhancement within their walls. The adjacent mesentery is also markedly edematous. Free fluid of moderate extent in pelvis and also surrounding liver and spleen. No free gas detected to suggest perforation. The superior mesenteric artery is intact, but the superior mesenteric vein is occluded by a thrombus, the leading edge of which extends into the distal end of the superior mesenteric vein, just proximal to its junction with the splenic veins. Large bowel and appendix relatively normal. Liver diffusely fatty.
Case Discussion
Features are those of small bowel infarction secondary to superior mesenteric vein thrombosis. The patient proceeded to laparotomy and small bowel resection.
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