Stein Nina,  Ahmed Fahran

Final Pr. ID: Poster #: CR-066

We present a radiologic case of a teenager with portal, inferior mesenteric, superior mesenteric, and splenic vein thromboses presenting with acute abdominal pain and treated conservatively with anticoagulation therapy. Ultrasound and computed tomography were done at the acute presentation and follow up magnetic resonance images were performed. One year of anticoagulation therapy correlated with almost complete resolution of splanchnic thrombosis; however, the superior mesenteric vein continues to remain severely dilated close to the confluence on subsequent annual imaging. The initial imaging also diagnosed multiple phlebolith in the pelvis. We suspect this is a congenital malformation of the porto-splanchnic circulation presenting with acute thrombosis. Differential is variceal dilatation as sequela of extensive thrombosis. Read More

Authors:  Stein Nina , Ahmed Fahran

Keywords:  Splanchnic Venous Thrombosis, Portal Venous Aneurysm, Mesenteric Vein Thrombosis, Portal Vein Thrombosis, Anticoagulation

Panesar Harsimran,  Beekman Alexander,  Martin Laura,  Armstrong Katherine,  Hodes Aaron

Final Pr. ID: Poster #: CR-006

Midgut volvulus in children is uncommon, but diagnosis of portal vein thrombosis in association with midgut volvulus has been rarely reported. We present a case of a 3-year old male with an unusual presentation of recurrent episodic abdominal pain suspected initially having ileocolic intussusception. Cross-sectional imaging identified extensive acute portomesenteric thrombosis in the setting of suspected midgut volvulus, which was confirmed on upper GI series and at surgery. A thrombophilia workup was negative. To our knowledge, this is the first case of acute portal vein and superior mesenteric vein thrombosis with splenic vein extension in association with midgut volvulus. When the diagnosis remains elusive and imaging demonstrates an extensive acute PVT with SMV extension in children and adolescents, radiologists should consider midgut volvulus in addition to other etiologies, such as malignancy, cirrhosis, or bowel inflammation. Read More

Authors:  Panesar Harsimran , Beekman Alexander , Martin Laura , Armstrong Katherine , Hodes Aaron

Keywords:  Portal vein thrombosis, Superior mesenteric vein thrombosis, Midgut volvulus