Presentation
Obstructive jaundice with cholelithasis for 3 years.
Patient Data
Small liver with a lobulated border and hypertrophy of the caudate lobe. The portal vein is normal (1.2 cm). Splenomegaly with homogenous signal intensity (16.7 cm).
The gallbladder contains several large calculi. The common bile duct is not distended (7.1 mm). No filling defects in the common bile duct. Distension of the common bile duct with no obstructive calculus demonstrated. Intrahepatic bile duct dilatation.
The pancreas shows normal signal with no duct dilatation. The kidneys appear normal. No abnormalities in the gastrointestinal tract. The visualized chest and spine appear normal.
Case Discussion
Features suggestive of cirrhosis with portal hypertension: Irregular border to the liver, hypertrophy of the caudate lobe and splenomegaly. In portal hypertension the portal vein is often distended, but is at the upper limit of normal in this case. Ultrasound can also be considered in this case for confirmation, as hepatofugal blood flow can be demonstrated with color Doppler.
Gallstones are demonstrated within the gallbladder.
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