Cirrhosis and portal hypertension

Case contributed by Bruno Di Muzio
Diagnosis certain


Derranged LFTs and distended abdomen. No prior medical history.

Patient Data

Age: 75 years
Gender: Female



The liver is small, has coarse echotexture, and irregular contours consistent with cirrhosis. Small calcified left hepatic lobe granulomas, no suspicious liver lesions. 

The portal vein is patent and has anterograde flow. Hepatic veins are patent but show decrease in phasicity and truncation of the a wave. Recanalization of the paraumbilical vein. 

Spleen is not enlarged. 

Large amount of ascites and left pleural effusion. 

Case Discussion

Sonographic features are consistent with cirrhosis: small volume, irregular liver contours, and coarse echotexture. On Doppler, hepatic veins show decreased phasicity commonly seen in cirrhosis. 

Recanalization of the paraumbilical vein and ascites support portal hypertension

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