Flow artifact mimicking portal vein thrombus

Case contributed by Dr Jeremy Jones

Presentation

Abdominal pain, raised amylase; treated as pancreatitis, but not improving.

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Case Discussion

Pancreatitis was diagnosed on admission, but despite standard therapy, there was limited improvement with worsening abdominal pain.  

Initial arterial phase CT raised the suspicion of portal vein thrombus. However, the subsequent portal venous phase CT shows normal enhancement of the portal vein.

The apparent portal vein thromus is the result of admixing of contrast enhanced blood from the splenic vein and non-contrast enhanced blood from the SMV causing a reduction in attenuation.

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Case information

rID: 13321
Case created: 28th Mar 2011
Last edited: 16th Oct 2015
Inclusion in quiz mode: Included

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