Portal venous system calcification

Case contributed by Dr Rudolf Kuhn

Presentation

Previously diagnosed with liver cirrhosis and currently presenting with hematemesis and melena.

Patient Data

Age: 35 years
Gender: Female

The main portal vein and its main tributaries (superior mesenteric vein = 0.6 cm and splenic vein = 1.4 - 1.9 cm) are markedly dilated. Calcifications are seen lining the walls of the main portal and splenic veins. Collateral circulation is demonstrated via the left gastric/coronary vein-esophageal varices, retrogastric veins and splenorenal collaterals.

The spleen is markedly enlarged (splenic index = 9436.9).

Perihepatic and perisplenic ascites are likewise seen.

Case Discussion

This is a case of long-standing portal hypertension in a patient previously diagnosed with liver cirrhosis. The etiology of the liver cirrhosis appears to pre-sinusoidal.

 

Case seen in collaboration with Drs. Glenn Ignacio,  Josemaria Demigillo and Dan Jared Masiddo.

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