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Case contributed by Mohammad Taghi Niknejad
Diagnosis almost certain


Work up for progressive abdominal distention and elevated liver enzymes.

Patient Data

Age: 60 years
Gender: Male

Massive abdominopelvic ascites are seen.

The liver is atrophic and shows marginal irregularity in keeping with cirrhosis. No hepatic mass is identified in the current study.

The main portal vein is dilated up to 15 mm.

The gallbladder is not seen at the anatomical location due to prior resection.

The spleen is enlarged, and its cephalocaudal height is measured 145 mm. 

The prostate gland is enlarged. 

Mild degenerative changes as osteophytosis are seen in the lumbar spine.
Grade I spondylolisthesis of L5 on S1 is present. 

Case Discussion

Cirrhosis with massive ascites; evidence of portal hypertension and splenomegaly.

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