肠系膜静脉血栓性静脉炎的影像学表现

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1、MesentericVenousThrombophlebitis:AComplicationofDiverticulitisRashmiJayadevan,MSIVAlbanyMedicalCollegeDr.GillianLiebermanOutlineOurPatientDiverticulitisPathogenesisComplicationsUniqueComplicationCompanionCasesBacktoourpatientOurPatientJ.S.:HistoryHPI60year-oldmalewithonewee

2、khistoryofnausea,vomiting,epigastricpainandintermittentdiarrheaUnabletotoleratePOintakeexceptforclearliquidsPE:T101Labs:WBC-33,300,MildlyelevatedLFT’sandAlkPhosPMHAdenocarcinomaofthelung,Hodgkin’sLymphoma,MI,TIA,SBOx2,skincancer,hyperlipidemia,HTNSurgicalHxSplenectomy,cholecy

3、stectomy,CABG,MohsresectionOurPatientJ.S.:RUQDopplerU/S•Antegrademinimallypulsatileflowconsistentwithwithportalwaveform•ConfirmsthatultrasoundimagesincludedtheportalveinBIDMCPACSOurPatientJ.S.:RUQU/SEchogenicfillingdefectinportalveinBIDMCPACSBIDMCPACSOurPatientJ.S.:PortalVenousFlowS

4、tudiesBIDMCPACSBIDMCPACSNon-OcclusivePortalVenousThrombosis:•Nowalltowallflowseen•Fillingdefectdoesnotshowsignsofvascularity•FlowseendistaltothrombusPortalVenousThrombosis:DifferentialDiagnosisLocalFactorsSystemicFactorsLivercirrhosisInheritedFactorVLeidenHepatobiliaryMalignancy

5、ProteinC/SdeficiencyIntra-abdominalinfectionAntithrombinIIIdeficiencyDiverticulitisPancreatitisAcquiredAppendicitisOCPsIBDPregnancyMalignancyInjurytoportalveinMyeloproliferativeDisordersSplenectomyAbdominalSurgeryHoekstraJ,JassenHA.Vascularliverdisorders(II):portalvei

6、nthrombosis.TheNetherlandsJournalofMedicine.2009.Febl;67(2):46-53LetscontinueontoseethenextstudythatourpatientreceivedOurPatientJ.S.:PortalVenousThrombosisonCTHypodensefillingdefectattheportalconfluenceBIDMCPACSAxialC+CTImageOurPatientJ.S.:PortalVenousThrombosisonCTThrombosisofposte

7、riorbranchofrightportalveinBIDMCPACSAxialC+CTImageAJROnline:http://www.ajronline.org/cgi/content-nw/full/183/4/1055/FIG1OurPatientJ.S.:PortalVenousThrombosisonCTThrombusattheportalvein/SMVconfluenceBIDMCPACSCoronalReformattedC+CTButwait…there’smore!OurPatientJ.S.:DiverticulitisonCT

8、Diverticulosisofthe