Ischemic colitis due to obstruction of mesenteric and splenic veins: A case report

Figure 1 Colonoscopic findings. A, B: Tortuous and dilated submucosal veins in the colonic mucosa; C: Diffuse and edematous mucosa with fine granularity resembling ulcerative colitis; D: A deep ulceration at rectosigmoid junction.

Figure 2 Dynamic abdominal CT. A: The normal anatomy of the main portal vein and its tributaries including the portal vein (PV), left gastric vein (LGV), gastrocolic trunk (GCT), splenic vein (SV), SMA, SMV, and IMV are schematically illustrated; B: The normal mesenteric vein (SMV and IMV) and splenic vein are absent. Numerous collateral venous channels developed to drain venous blood from gastrointestinal tract to portal vein.

Figure 3 Abdominal CT arteriography. A: Normal shape and course of SMA, IMA, and splenic artery, tortuous and dilated distal branches of SMA and IMA around rectosigmoid colon; B: An axial and C: Coronal reformatted abdominal CT reveal the absent splenic vein, SMV, and IMV with numerous intra- and peripancreatic collaterals. Distal end portal vein is abruptly ended (black arrow) and SMA is normal (white arrow). Note prominent dilated pericolic arteries and venous collaterals, and markedly thickened sigmoid colon.