Liver cirrhosis with portal hypertension

Case contributed by Dr Abdallah Alqudah

Presentation

History withheld.

Patient Data

Age: 72 years
Gender: Female

There is irregular wavy contour of the liver with, no definite focal lesion seen.

Splenomegaly is noted with large number of varices and dilated veins seen at the gastroesophageal junction and in the splenorenal region (spleno-renal shunt). Dilated portal vein, splenic vein as well as the left ovarian vein down to the pelvis where tortuous dilated parauterine vessels are seen. Findings are in keeping with portal hypertension.

Congested mesenteric vessel mostly secondary to the above mentioned portal hypertension.

Dilated IVC seen with patent IVC and hepatic veins, with multichamber cardiomegaly seen in the imaged chest.

Case Discussion

The CT findings of irregular nodular surface of the liver strongly suggest diffuse liver pathology most likely cirrhosis. 

The clear dilatation of the portal, splenic and left ovarian vein as well as the presence of varices in the gastroesophageal and the spleno-renal regions are in keeping with portal hypertension.

The dilation of the IVC, multichamber cardiomegaly along with ground glass opacity and interlobular septal thickening (not seen in these images) may suggest heart failure.

This is a 72 year-old female has known cirrhosis. She has no history of alcohol use or viral hepatitis. Considering that, one should consider cardiac cirrhosis as one of the differentials. 

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Case information

rID: 48669
Case created: 19th Oct 2016
Last edited: 23rd Oct 2016
Inclusion in quiz mode: Included

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