W. Weiwad, L. Hinz (Halle)  

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17 Years  

Male  

Abdomen-Vessels  

circulatory  

17 year-old male. Unspecific immune defect with multiple organ manifestations (juvenile chronic arthritis, factor V mutation, ulcerative colitis, autoimmune hepatitis, retarded growth, celiac disease, IgA deficiency, cholelithiasis, suspected Evans syndrome). Findings after splenectomy.

On the day of admission the patient presented uncharacteristic upper abdominal symptoms, which were initially explained as the known (sonographically proven) cholelithiasis.  

The cavernous transformations of the vena portae is defined as the development of venous collaterals within or around the previously thrombosed vena portae.  

<- view Ultrasound 1

Ultraschall 1: (B-image) Despite heparinization after 14 days, a convoluted venous vessels were seen in the hepatic hilus in B-images and colored doppler. A continuous edge of the portal vein is no longer possible.



<- view Ultrasound 2

Ultraschall 2: (Colored doppler)

In ultrasound examinations on the day of admission, there was missing flow in the portal vein (images not shown).

 

Imaging including endoscopy  

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N/A  

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N/A  

1. Medline:
De Gaetano AM; Lafortune M; Patriquin H; De Franco A; Aubin B; Paradis K
Cavernous transformation of the portal vein: patterns of intrahepatic and splanchnic collateral circulation detected with Doppler sonography
AJR Am J Roentgenol 1995 Nov;165(5):1151-5  

Cavernous, transformation, portal, vein, cholelithiasis, IgA, deficiency, autoimmune, portal vein, cavernous transformation, development of venous collaterals, portal vein thrombosis, child, childhood, pediatric radiology  

W Weiwad, L Hinz. Cavernous transformation of the portal vein. PedRad [serial online] vol 2, no. 1.
URL: www.PedRad.info/?search=20020116092119