Fig. 12.

A 33-year-old male patient with an unremarkable past medical history presented to the ER with diffuse abdominal pain and progressive abdominal distention. a Coronal plane postcontrast abdominal CT image showed a large bland thrombus obliterating the main portal vein (arrowheads), edematous small bowel loops, and diffuse ascites. b Axial plane image of the same CT study better demonstrated target-like wall thickening of the small bowels (arrows). Imaging findings were found to be consistent with veno-occlusive mesenteric ischemia. Emergent surgery confirmed imaging findings. Hematological work-up after surgery diagnosed factor V Leiden mutation-associated thrombophilia. c 3D illustration of portal vein branches (SV splenic vein, SMV superior mesenteric vein, MPV main portal vein, RHPV right portal vein, LHPV left portal vein) and d the representation of the thrombus lying along the main portal vein