Cirrhosis and portal vein thrombosis

Case contributed by Dr Bruno Di Muzio

Presentation

Hepatitis B.

Patient Data

Age: 55 years
Gender: Male

Abdominal ultrasound

Ultrasound

The liver is reduced in size, with jagged edges and diffusely heterogeneous echotexture (granular appearance). Enlarged spleen. The portal vein is bordered with difficulty, with hypoechoic material inside. There is no flow at color and spectral Doppler.

Case Discussion

Typical sonographic features of cirrhosis characterized by coarse liver echotexture and nodular surface. Although no focal suspicious lesions for HCC were seen on this ultrasound, in the setting of portal venous thrombosis, a further assessment with multiphase CT is recommended to rule out tumoral thrombus. 

Cirrhosis is the common endpoint of a wide variety of chronic disease processes which cause hepatocellular necrosis.

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