We report a very rare case of acute congestive ischaemic colitis of the left colon caused by brutal decompensation of an uncommon arteriovenous malformation (AVM) in the territory of the inferior mesenteric artery (IMA) in a 45-year-old male patient. The patient presented with severe abdominal pain in the left iliac fossa and abundant mucoid stools. The diagnosis of congestive colitis was made by optical colonoscopy but the full diagnosis of the responsible AVM in the IMA territory was made by contrast-enhanced multidetector CT scan combined with colour Doppler ultrasound. Two successive attempts at selective embolization failed to resolve the symptoms and finally, extensive surgery was necessary. The complete imaging findings of the case are presented and the characteristic features of uncommon AVMs and fistulas of the IMA territory are briefly reviewed.

We report two cases of elderly patients presenting with life-threatening complications due to inadvertent accidental ingestion of blister pill packs (BPPs). The first patient presented with obstruction followed by anemia and finally perforation of the small bowel. The second presented with rapidly lethal mediastinitis due to a large perforation of the lower esophagus. The responsible BPPs were identified by multidetector computed tomography and the best result in their characterization was obtained through maximal intensity projections and volume rendering reformations.

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Case ReportA 53-year-old female with a long history of severe episodes of acute pancreatitis was admitted with complaints of recurrent epigastric pain. Contrast-enhanced computed tomography (CT) -at day one -demonstrated only a small infracentimetric pseudocyst in the pancreatic tail, but peripancreatic effusions were absent at this time. Chronic calcified retracted sequelae of previous pseudocysts were still visible along the anterior aspect of the corporeo caudal pancreas. A stent was present in the cephalic Wirsung, and chronic collateral venous pathways had developed along the great and lesser curvatures of the stomach. The splenic vein was patent (Figure 1 left).Severe recrudescence of symptoms after one week justified a new contrast-enhanced CT at day nine after admission. Effusions had now developed in the retro caudal pancreatic area, causing acute collapse of the splenic vein (black arrows on Figure 1). As a consequence, acute venous collateralization (Figure 2 maximal intensity projections, Figure 3 volume rendering views) amplified, causing an increase of the caliber of the already dilated main gastroepiploic vein (black arrow on Figures 2 and 3) and unusual varicose vein dilatation of the omental venous arch of Barkow (white arrows on Figures 2 and 3). DiscussionGastric varices may classically develop as a collateral venous pathway when isolated splenic vein occlusion occurs during various diseases. Dilatation of the main gastroepiploic vein that runs along the great curvature of the stomach may also occur. Most of these different collateral pathways are spontaneously opacified during contrast-enhanced CT, particularly in patients with a long history of chronic pancreatitis or recurrent episodes of acute pancreatitis.The speed of development of these collateral pathways remains unknown. It probably depends on the speed of

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