PMC3838809_01
Axial contrast-enhanced (a) and coronal reconstruction (b) CT images obtained at the level of the lower abdomen show an enlarged and thick-walled appendix (arrows), with evidence of stranding of the surrounding mesenteric fat (curved arrow in (b)).
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fig1
It revealed a dilated, hyperenhancing appendix, with surrounding mesenteric densification, indicative of acute appendicitis (Figure 1).
Axial contrast-enhanced CT images acquired at the level of the small-bowel mesentery root show nonenhancing low-attenuation thrombi within the lumen of the superior mesenteric vein tributaries (a) and superior mesenteric vein (b). In (b), the normal superior mesenteric artery is identified (curved arrow).
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There was an acute thrombus distending the lumen of the superior mesenteric vein and its tributaries, with inflammatory changes in the surrounding fat (Figure 2).
Axial contrast-enhanced CT images obtained through the midportion of the liver show thrombosis of the main portal branches (a) extending to the portal branch to the posterior segments of the right lobe.
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There was also portal vein thrombosis (Figure 3). 
Color Doppler ultrasound image demonstrates multiple tortuous venous structures in the hepatic hilum, keeping with the cavernomatous transformation of the portal vein.
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Abdominal and pelvic evaluation with ultrasound demonstrated cavernomatous transformation of the portal vein (Figure 4).