Chronic portal venous thrombosis with cavernous transformation

Case contributed by Dr Shumaila Auqil
Diagnosis almost certain


Pain right hypochondrium for 2 months. No history of fever.

Patient Data

Age: 35 years
Gender: Female

Non-opacification of the main portal vein and its main left and right intrahepatic branches and part of SMV at the porto-venous phase.

Multiple collateral vessels at the porta hepatis, perigastric and peripancreatic area. Moderate splenomegaly also evident. No ascites.

Findings are consistent with chronic portal vein thrombosis. 

The patient received anticoagulant therapy for about 2 months and then came for follow up ultrasound, which shows complete resolution of previously noted portal vein thrombosis and replacement of main portal vein channel and its main intrahepatic branches by multiple collateral channels; consistent with cavernous transformation.

Case Discussion

In this 35-year-old female patient presenting with right hypochondrial pain with digestion problems, imaging findings were consistent with chronic portal venous thrombosis. Chronicity was suggested by formation of collateral channels and secondary congestive splenomegaly.

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