Portal vein calcification

Last revised by Dr Jeremy Jones on 20 Sep 2021

Portal vein calcification is a rare radiologic finding which can be seen in long-standing portal venous hypertension.

Calcium may be deposited in a thrombus or in the wall of the portal vein and is more rarely found in the splenic vein and superior mesenteric vein.

One of the proposed mechanisms includes mechanical stress leading to sclerosis and calcification within the thickened intima and media of the vein.

Calcifications in the portal veins can be of clinical significance as they may be a sign of radiographically occult portal vein thrombosis, which is then discovered during surgery. Transjugular intrahepatic portosystemic stent shunting may also be difficult to perform in these patients 1.

Portal vein calcification carries a strong association with long-standing portal venous hypertension regardless of the underlying etiology and a less stronger association with cirrhosis. It can rarely be associated with other entities such as hepatocellular carcinoma 1, 2.

It can be occasionally discovered on plain abdominal radiographs or is better demonstrated on CT scan,  which can also show concurrent splenic vein and superior mesenteric vein calcification 1.

It was thought to be first described by Moberg in 1943 on a radiograph.

ADVERTISEMENT: Supporters see fewer/no ads

Cases and figures

  • Case 1
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.