Published online Jan 27, 2021. doi: 10.4240/wjgs.v13.i1.87
Peer-review started: September 17, 2020
First decision: November 16, 2020
Revised: November 30, 2020
Accepted: December 10, 2020
Article in press: December 10, 2020
Published online: January 27, 2021
Processing time: 119 Days and 6.9 Hours
Anastomosis of the testicular vein with the superior mesenteric vein rarely causes severe gastrointestinal bleeding. To date, there have been few studies describing its appearance on medical imaging. Here, we present multidetector computed tomography three-dimensional and multiplanar reconstruction (MPR) images of a typical digital subtraction angiography showing proven ectopic bleeding and provide the first review of the image performance.
A 68-year-old man who had been rushed to the hospital with a four-day history of melena and fainting underwent multiple esophagogastroduodenoscopy procedures that failed to identify the source of bleeding. We used MPR combined with three-dimensional reconstruction images, and found that the testicular vein had anastomosed with the superior mesenteric vein, and they clustered together in the jejunal vessel wall, which caused severe gastrointestinal bleeding. Digital subtraction angiography confirmed the location of bleeding. After transfusion and embolization therapy, the patient’s condition improved.
Computed tomography-MPR combined with three-dimensional images offers significant value in the localization and qualitative assessment of rare gastrointestinal hemorrhage. The features of multiphase spiral scanning can improve the accuracy of the diagnosis.
Core Tip: We report a case of anastomosis of the testicular vein with the superior mesenteric vein that caused severe gastrointestinal bleeding. We used multidetector computed tomography three-dimensional and multiplanar reconstruction, and found that the testicular vein had anastomosed with the superior mesenteric vein, and gathered together in the jejunal vessel wall. Digital subtraction angiography confirmed the location of bleeding. After vascular intervention, the patient’s symptoms significantly improved.