Purpose: The purpose of this work was to assess CT demonstration of the enlarged gonadal vein as a portosystemic shunt of mesenteric varices.
Method: The clinical records and CT images of eight patients with angiographically confirmed mesenteric varices were studied retrospectively. We measured the size of the right gonadal vein of these eight patients and also measured the size of the right gonadal vein in 60 patients without mesenteric varices.
Results: In all eight patients, CT demonstrated that the mesenteric varices drained into the inferior vena cava through the dilated right gonadal vein (diameter 6-10 mm) in all and that the left gonadal vein was not dilated (diameter 2-3 mm). In 60 patients without mesenteric varices, the diameter of the right gonadal vein was 1-5 mm.
Conclusion: CT demonstrates the dilated gonadal vein as a portosystemic shunt of the mesenteric varices. Awareness of a dilated gonadal vein in patients with portal hypertension may be helpful to consider the possibility of mesenteric varices.