J Korean Soc Radiol.  2013 Jul;69(1):67-70. 10.3348/jksr.2013.69.1.67.

Septic Thrombophlebitis of the Inferior Mesenteric Vein and Associated Mesenteric Abscess Complicating Sigmoid Diverticulitis: A Case Report

• Cha S
• Lee HK
• Yi BH
• Lee MH
• Hong HS

• KMID: 2002892
• DOI: http://doi.org/10.3348/jksr.2013.69.1.67

Abstract

Thrombophlebitis occurs secondarily to inflammatory conditions of adjacent organs, and radiologic finding is essential for diagnosis. However, because of the rarity on clinical cases that involve the inferior mesenteric vein, many radiologists are unfamililiar with its location and appearance. We experience a case of septic thrombophlebitis with abscess complication sigmoid diverticulitis. CT scans reveals a low density thrombus and air in the inferior mesenteric vein, combining with perivascular fat infiltration, and focal wall defects with abscess formation. After surgical treatment, the abscess was not visible in the follow-up CT scans. Septic thrombophlebitis of the inferior mesenteric vein, although being a rare disease, should be diagnosed on CT according to the given unique location, the appearance of inflamed vein and the adjacent descending mesocolon.

MeSH Terms

Abscess
Colon, Sigmoid
Diverticulitis
Follow-Up Studies
Mesenteric Veins
Mesocolon
Rare Diseases
Thrombophlebitis
Thrombosis
Veins

Figure

• 

  Fig. 1 A 72-year-old man with septic thrombophlebitis of the inferior mesenteric vein complicating sigmoid diverticulitis. A-D. Axial contrast-enhanced CT scans of the abdomen and pelvis show air (thick arrow) in the splenic vein (A) and low-attenuation thrombus (thin arrow) in the inferior mesenteric vein (B) which is maximally dilated at the level of the renal hilum. Mesenteric abscess (open arrow) filled with pus and air (C) is connected with focal wall defect (arrowhead) of the thrombosed inferior mesenteric vein (B). Sigmoid colon (D) shows multiple diverticula with inflamed diverticulum and pericolic fat infiltration, representing sigmoid diverticulitis. E. Coronal reformatted image shows the dilated, thrombused inferior mesenteric vein with focal perforation (arrowhead).

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