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Noncirrhotic idiopathic portal hypertension

Case contributed by Kewal Arunkumar Mistry
Diagnosis probable

Presentation

Non alcoholic, presented with upper GI bleed.

Patient Data

Age: 40 years
Gender: Female

Ultrasound compatible with portal hypertension:

  • dilated portal vein
  • thick echogenic portal vein walls
  • splenomegaly
  • dilated splenic vein with marked splenomegaly
  • normal sized liver with normal outline and echotexture
  • Duplex Doppler showing hepatopetal flow in main portal vein however with loss of phasicity

Normal-sized liver with dilated portal and splenic veins as well as marked splenomegaly. Subtle dilated submucosal vessels, suggestive of varices, are also visible in the lower esophagus and fundus of stomach.

Case Discussion

Patient does not have a history of alcohol abuse. Liver functions are normal.

Imaging is suggestive of noncirrhotic idiopathic portal hypertension.

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