Presentation
Patient with congestive heart failure and chronic kidney disease presented to the ER with several days of pain in the right upper quadrant of the abdomen and dyspnea.
Patient Data
Age: 50 years
Gender: Male
From the case:
Congestive heart failure - starry sky appearance
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The generalized increase in echogenicity of the walls of the portal vein scattered throughout the liver can be observed contrasting with the diffusely hypoechoic and edematous parenchyma giving it the starry night appearance.
Case Discussion
In a patient with congestive cardiac failure, the presence of a "starry night " appearance of the liver on ultrasound is considered a nonspecific finding. It has been associated with venous congestion due to right-sided heart failure and is not pathognomonic of acute hepatitis.1-4