Sigmoid diverticulitis complicated by IMV thrombophlebitis

Case contributed by Vikas Shah
Diagnosis almost certain

Presentation

Left lower quadrant pain, fever and raised inflammatory markers.

Patient Data

Age: 40 years
Gender: Male

Sigmoid diverticulosis complicated by mild pericolic edema. Inflammatory streaking of the fat extends up the left retroperitoneum, with low density within the inferior mesenteric vein and some of its tributaries near the sigmoid colon, all the way to its drainage into the splenic vein. No portal vein thrombosis. No perforation or fluid collection.

Case Discussion

Sigmoid diverticulitis may be complicated by a number of events, including abscess formation, perforation or fistulation. One more to be aware of is associated venous thrombophlebitis - this may affect the adjacent inferior mesenteric vein or left gonadal vein. IMV thrombophlebitis may lead to portal vein thrombosis or seeding of hepatic abscesses.

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