Mesenteric vein thrombosis; not going with the flow.

A 71-year-old woman presented with a 2-week history of epigastric pain, nausea and vomiting; on examination she demonstrated signs of peritonism. CT imaging was performed and this demonstrated extensive thrombosis of the superior mesenteric, omental and portal veins with infarction of the distal small bowel. A non-operative approach was initiated and anticoagulation rapidly started. Within 48 h the patient demonstrated significant clinical improvement and she subsequently made a full recovery.