Presentation
Abdominal Distension
Patient Data
The hepatic segment of the IVC is distended and occupied by a heterogenous, enhancing soft tissue mass with central low attenuation that extends upward to the right atrium.
Hepatic parenchyma shows a heterogeneous mottled appearance but with a smooth regular outline, and no focal lesion.
Moderate ascites.
Small gall bladder calculi.
Case Discussion
The patient complained of gradually progressive abdominal distension.
Laboratory investigations revealed derangement of liver enzymes warranting further evaluation.
The CT abdomen revealed IVC occlusion and distension a by soft tissue mass suggesting leiomyosarcoma of IVC, heterogeneous liver parenchyma and moderate ascites consistent with the development of acute budd-Chiari syndrome.
Case courtesy of Riyad Waheed Alesawi, consultant radiologist.
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