Portal venous system calcification
Previously diagnosed with liver cirrhosis and currently presenting with hematemesis and melena.
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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 seen in collaboration with Drs. Glenn Ignacio, Josemaria Demigillo and Dan Jared Masiddo.