Presentation
Left lumbar pain.
Patient Data
Replacement of the normal single channel portal vein with numerous tortuous enhancing collateral vessels are seen in the peripancreatic region and porta hepatis indicative of cavernous transformation of the portal vein. Draining into the collateral vessels is the dilated splenic vein. The superior mesenteric vein and its tributaries are likewise dilated and appear to drain into the afore mentioned collaterals. The right and left intrahepatic branches of the portal vein are attenuated.
The liver shows mild atrophic left lateral segments (segment II and III) with hypertrophy of the caudate lobe and segment IV, the liver shows fat density.
Wandering spleen is mildly enlarged and seen at the left lumbar region.
Calculous cholecystitis.
Inflammatory bowel disease in the form of fat submucosal deposition seen in the descending colon, sigmoid colon and the rectum (fat halo sign), with diffuse loss of the colonic haustrations.
Case Discussion
Cavernous transformation of the portal vein (CTPV) is a sequela of portal vein thrombosis and is the replacement of the normal single channel portal vein with numerous tortuous venous channels.
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