Superior mesenteric and portal vein thrombosis
Antecedent of laparoscopic cholecystectomy 3 days ago, now with severe abdominal pain.
CT abdomen and pelvis
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Computed tomography demonstrated a large filling defect of contrast in the superior mesenteric vein and portal vein, this is associated with a diffuse increase in mesenteric fat. Also CT shows, infarct in the left lobe liver and spleen. No filling defects in arterial phase are seen, and signs of mesenteric ischemia are demostrated.
In this case mesenteric vein thrombosis and portal vein is demonstrated with hepatic and splenic infarct.
Portal vein thrombosis is a rare but recognised complication of cholecystectomy (and other intra-abdominal surgeries). It may be related to pneumoperitoneum, direct trauma and/or an underlying hypercoagulable state 1.