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Portal venous varix

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Abdominal pain. Incidental liver lesion.

Patient Data

Age: 30 years
Gender: Male
ultrasound

The liver is mildly enlarged with increased echopattern and posterior acoustic attenuation, reflecting diffuse steatosis.

Left portal vein focal dilatation reaching 16 mm in diameter with turbulent flow seen as yin-yang sign on color Doppler, in keeping with a portal vein varix. 

Case Discussion

Portal venous varix is usually asymptomatic and incidentally discovered. Further work-up is not necessary. Color Doppler imaging is the most helpful in diagnosis identifying turbulent flow within and differentiating it from hepatic cysts.

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