Presentation
Abdominal distension.
Patient Data
The hepatic veins cannot be identified.
The intra-hepatic portion of the inferior vena cava reveals narrow caliber.
The liver shows irregular contour with an inhomogeneous and mottled appearance.
The caudate is significantly enlarged.
The portal vein is dilated, measured 21 mm in diameter. No evidence of thrombosis.
The spleen is homogeneously enlarged in size without focal lesion.
Mild free fluid is noted in the perihepatic region as well as in the pelvis.
Case Discussion
The features are compatible with chronic Budd Chiari syndrome complicated by portal venous hypertension. Hypertrophy of the caudate lobe is an indicator of chronicity of the disease.
Dr. Mohammed Tahir Aien has also contributed to this case.
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