Liver cirrhosis

Case contributed by Hani M. Al Salam
Diagnosis almost certain

Presentation

Chronic hepatitis B.

Patient Data

Age: 35 years
Gender: Male
ct
This study is a stack
Axial
non-contrast
This study is a stack
Axial C+
arterial phase
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Coronal C+ portal
venous phase
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Info

Triphasic liver CT was conducted and reveals the liver to have increase density with irregular nodular surface and parenchyma, consistent with cirrhosis.

No enhancing nodule seen during the arterial phase to suggest HCC.

Huge splenomegaly is seen. Distended and engorged paraumbilical veins, which are seen radiating from the umbilicus across the abdomen to join the systemic veins (Caput Medusae) indicative of severe portal hypertension.

Multiple lienorenal and gastrosplenic varices. 

Normally opacified portal, SMV and splenic veins. No evidence of cavernous transformation of the portal vein. 

Moderate right sided pleural effusion. 

ultrasound
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US abdomen showed the liver to have irregular surface with coarse nodular echotexture, suggestive of cirrhosis. 

Patent portal vein. 

Case Discussion

Known case of chronic hepatitis B infection with liver cirrhosis and signs of portal hypertension.

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