46 year-old male of nephrotic syndrome. CT scans shows acute superior mesenteric vein thrombosis (black arrow) with bowel wall thickening (white arrowhead), mesenteric edema (black arrowhead) and ascites. Note the normal SMA enhancement (white arrow) and ratio of SMV to SMA diameters > 2. He did not receive surgery but was treated with anticoagulation therapy. Follow-up CT showed abundant collateral veins and no bowel necrosis. SMA = superior mesenteric artery, SMV = superior mesenteric vein