Patient Data
Appearances in this contrast-enhanced CT scan obtained during portal venous phase:
Enhancing lesions with beaded appearance are seen at the porta hepatis. These represent the collaterals which have replaced the thrombosed portal vein. The collaterals also extend to the intraparenchymal portal branches, pericholecystic collaterals and coronary veins.
Other visible signs of portal vein thrombosis are hypertrophy of liver segment IV and Caudate lobe and atrophy of left and right lobes. Note right displacement of the gallbladder fossa due to segment IV hypertrophy.
Annotated images showing:
- porta hepatis collaterals (black arrowed)
- intraparenchymal portal branches (black arrowhead)
- pericholecystic collaterals (blue arrow)
- hypertrophy of liver segment IV and the caudate lobe
Case Discussion
In the contrast-enhanced CT scan obtained during portal venous phase:
Multiple tortuous vessels are seen at the porta hepatis. These represent the collaterals which have replaced the thrombosed portal vein. The collaterals also extend to the intraparenchymal portal branches, pericholecystic collaterals and coronary veins. Other visible signs of portal vein thrombosis are hypertrophy of liver segment IV and caudate lobe and atrophy of left and right lobes. Note, right displacement of the gallbladder fossa due to segment IV hypertrophy. Ascites is most likely due to portal hypertension.
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