Presentation
Previously diagnosed with liver cirrhosis and currently presenting with hematemesis and melena.
Patient Data
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.