Portal biliopathy

Case contributed by Dr Eslam Taha

Presentation

Given history of previous cholecystectomy with current history of abdominal pain

Patient Data

Age: 45 years
Gender: Female
MRI
  • attenuated portal vein and its main branches with portal cavernoma formation at the porta hepatis and peripancreatic regions seen encasing and attenuating the common hepatic and common bile ducts with consequent mild proximal intrahepatic biliary radicles dilatation
  • few small dark signal filling defects are seen within the left intrahepatic biliary radicles
  • low insertion of the cystic duct
  • the main pancreatic duct is not dilated
  • enlarged liver showing left hepatic lobe segment II focal area of abnormal high T2 signal measures about 1 cm in diameter
  • enlarged spleen
  • dilated portosystemic collaterals at splenic hilum and beneath anterior abdominal wall
CT
  • attenuated portal vein and its main branches with portal cavernoma formation at the porta hepatis and peripancreatic regions seen encasing and attenuating the common hepatic and common bile ducts with consequent mild proximal intrahepatic biliary radicles dilatation
  • the main pancreatic duct is not dilated
  • hepatosplenomegaly
  • Dilated portosystemic collaterals at splenic hilum and beneath anterior abdominal wall.

Case Discussion

This case demonstrates attenuated portal vein with portal cavernoma formation encasing and attenuating CHD and CBD with consequent mild intrahepatic biliary dilatation (portal biliopathy). Background of hepatomegaly, splenomegaly and portal hypertension.

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Case information

rID: 75407
Published: 28th Mar 2020
Last edited: 30th Mar 2020
Inclusion in quiz mode: Included
Institution: Faculty of Medicine Helwan University

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