Liver cirrhosis

Case contributed by Hani Makky Al Salam
Diagnosis almost certain

Presentation

Chronic hepatitis B.

Patient Data

Age: 35 years
Gender: Male
ct

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

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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