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In this case we can appreciate several abnormal findings:
- Filling defect in the superior mesenteric vein: this is a direct sign of thrombosis. The vein has an internal hypodensity in the portal/venous phase. This thrombus has a density of 35 -40 HU.
- Filling defect in the portal vein: There is an extension of the thrombus to the portal vein, there is a partial filling defect in the anterior wall, witch can be seen partially extending to the right branch of the portal vein. There are no evidence of intrahepatic portal thombosis.
- Thickened wall of jejunum and ileum: due to edema secondary to venous obstruction. There is no evident wall enhancement maybe because of amount of IV contrast injected. There are no signs of intestinal infarct because of normal arterial perfusion.
- Dilated jejunum and ileum: with fluid filled loops an multiple air-fluid levels. This sign may indicates mechanical dysfunction due to vascular compromise.
- Engorged veins at mesentery and free fluid between loops: this is compatible with mesenteric vascular venous congestion. The fat stranding at this level indicates certain amount of inflammatory process.
- Ascites: it may indicates chronic liver disease or portal hypertension due to portal thrombosis.