Venous congestive ischemic colitis following left hemicolectomy: A rare case of superior rectal vein occlusion

Abstract

Ischemic colitis is primarily caused by arterial hypoperfusion, while venous obstruction is rarely documented as the primary cause, particularly as a postoperative complication. This report describes a 66-year-old man who presented with abdominal pain, cramping, and diarrhea 6 days after an elective left hemicolectomy. Contrast-enhanced CT was instrumental in identifying the vascular etiology, revealing an occlusion of the superior rectal vein alongside circumferential wall thickening and submucosal edema in the rectosigmoid colon. Histopathologic analysis confirmed the diagnosis, showing stromal necrosis, small-vessel thrombosis, and acute ischemic changes characteristic of venous congestive ischemic colitis. Following appropriate conservative management, including hydration and bowel rest, the patient achieved full clinical recovery without the need for surgical reintervention.