Background: Hypertension in the portal vein system stimulates the vascular system to develop a porto-caval collateral system, which occurs by adaptation of the already existing junctions between the porto-caval and the systemic circulation to changed conditions or by angiogenesis.
Case report: We present a case of a 42-year-old man with alcoholic cirrhosis of the liver and exacerbation of chronic pancreatitis, whose computed tomography of the abdominal cavity revealed a massive varicoid dilatation of a vein of the spleen with a splenorenal shunt and tortuous dilated venous vessels in the retroperitoneal space and mesentery.
Conclusions: The unusual image of the mesenteric and retroperitoneal venous vessels in our patient resulted from the coexistence of collateral porto-systemic circulation and compression of the left renal vein.
Keywords: computed tomography (CT); liver cirrhosis; nutcracker syndrome; portal hypertension; porto-caval collateral circulation; spontaneous splenorenal shunt.