Presentation
Obstructive jaundice
Patient Data
The liver is diffusely enlarged in size, segment 6 is crossing the lower pole of the right kidney and the left lobe is crossing the midline abutting the spleen (positive kissing sign). It measures 20 cm in CC diameter at the level of the midclavicular line. No focal lesion.
Periportal edema is seen. No dilatation of the intra- and extrahepatic biliary channels.
The gallbladder shows diffuse mild wall thickening (0.7 cm).
Few gallstones are seen within the lumen of the gallbladder.
Spleen is enlarged in size. It measures 15.4 cm in CC diameter. No focal lesion is seen.
Multiple enlarged lymph nodes are noted in the porta hepatis region. The largest measures 1.3 cm (short axis).
Hypodense lesion (?intramural fibroid) is seen in the anterior wall of the uterus. It measures about 1.6 x 1.3 cm.
Case Discussion
Diffuse hepatosplenomegaly with gallstones, diffuse gallbladder wall thickening, periportal edema, and enlarged porta hepatis lymph nodes.
These features may be seen in entities like acute viral hepatitis, hemolytic anemia, and other hematological disorders. Needs clinical and hematological workup.
No features of obstructive jaundice.