Cavernomatous Transformation of the Portal Vein in Crohn's Disease: An Unexpected Radiologic Finding.

Crohn's disease is associated with an increased risk of thromboembolic events due to chronic systemic inflammation and endothelial dysfunction. Portal vein thrombosis is a rare manifestation that may remain clinically silent and progress to cavernomatous transformation. We report the case of a 32-year-old male patient with ileal Crohn's disease in whom contrast-enhanced abdominal computed tomography (CT), performed for routine disease monitoring, revealed extensive chronic portal vein thrombosis with cavernomatous transformation. This case highlights the important role of cross-sectional imaging in diagnosing chronic splanchnic venous thrombosis in Crohn's disease, even in the absence of an acute inflammatory flare, and emphasizes the thrombotic mechanisms underlying inflammatory bowel disease.