Presentation
Presents with acute lower abdominal pain, no history of liver disease
Patient Data
Age: 85
Gender: Male
From the case:
Massive inferior mesenteric vein - portal hypertension
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Grossly cirrhotic liver and splenomegaly with a massively enlarged inferior mesenteric vein entering the pelvis associated with mutiple collaterals communicating with the left iliac vein
Case Discussion
One of the common porto-systemic collateral pathways that allows for decompression of raised portal venous pressure is the superior rectal vein (arising from the inferior mesenteric vein) entering the upper anal canal producing hemorrhoids. In this case there is an unusual anastomosis between inferior mesenteric vein branches and the left iliac vein
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