JBR-BTR : organe de la Société royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR)
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Pylephlebitis is a very rare and dangerous complication of inflammatory abdominal processes, mainly appendicitis (1) and diverticulitis (2). We describe a case of peridiverticular inflammation leading to a extensive phlebitis of the adjacent sigmoid vein, extending to the inferior mesenteric vein up to the proximal portal vein, with distal embolus into the left portal vein. Contrast CT and multiplanar reconstructions allowed early diagnosis, and with antibiotic and anticoagulation therapy, no liver abscess developed.
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We report on a healthy 39-year-old man who developed spontaneous pneumomediastinum during a soccer game without a traumatic impact. Chest radiography and CT demonstrated the extensive pneumomediastinum and subcutaneous emphysema. Treatment of this rare condition is conservative and prognosis is excellent.
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To analyze the CT findings in 20 cases of complicated small bowel obstruction with surgically and histopathologically proven small bowel ischemia, caused by extrinsic venous outflow obstruction of the affected bowel loops and to discuss the question, if bowel wall thickening, abnormal bowel wall enhancement, ascites and mesenteric stranding correlate with the severity of bowel wall damage. ⋯ Although highly sensitive and specific for small bowel ischemia in complicated small bowel obstruction, the presence and degree of bowel wall thickening, ascites or local mesenteric stranding at CT do not correlate with the severity of ischemic small bowel wall damage and even the presence of bowel wall enhancement does not exclude severe and potentially transmural bowel infarction in these patients.