Acute extensive portal and mesenteric venous thrombosis after splenectomy: Treated by interventional thrombolysis with transjugular approach

Figure 2 Case 2: A 43-year-old man with epigastric pain, diarrhea, fever, and vomiting for 1 wk. He had undergone splenectomy 3 wk previously. A: Selected axial image from admission contrast-enhanced CT, on postoperative day 21, shows thrombus (arrow) within the SMV; B: Pre-treatment direct venography via transjugular approach access to the portal vein shows extensive thrombosis of the SMV extending into the main PV and intrahepatic branches (arrows); C: Follow-up direct portal venography via the infusion catheter (curved arrow), obtained 6 d after the catheter infusion of thrombolytics, shows patent PV and SMV with only minimal residual wall thrombus (arrows); D: CT image at the same level as in Figure 2A obtained 6 d after the catheter infusion of thrombolytics, before the infusion catheter removal, shows the wide patent SMV (arrow) with only minimal residual wall thrombus. Note the infusion catheter within the SMV (curved arrow).