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Portal vein thrombus and liver infarction

Case contributed by Dr Jeremy Jones

Presentation

Severe abdominal pain and right upper quadrant tenderness. No significant past medical history.

Patient Data

Age: 55 years
Gender: Female

Geographic hepatic perfusion abnormality in keeping with left lobe of liver infarction, with pneumobilia and portal vein thrombus. 

Head-of-pancreas tumor with stent in-situ.

Moderate bilateral pleural effusions. Incidental note of tablets in the stomach and large simple renal cysts.

Case Discussion

There has been complete infarction of the left lobe of the liver following the large portal vein thrombus in a patient with pancreatic cancer. The pneumobilia and geographic perfusion abnormality are striking.

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