Presentation
Cavernous transformation of portal vein was detected incidentally in a young boy suffering from abdominal tuberculosis.
Patient Data
Multiple tortuous vessels are seen in the intrahepatic portion of the portal vein on color Doppler. Multiple large abdominal lymph nodes are also visible at the porta hepatis, suggesting associated abdominal tuberculosis. The patient had no history suggestive of specific symptoms of portal vein thrombosis.
Case Discussion
Cavernous transformation of the portal vein, also referred to as portal cavernoma, is characterized by the development of large collateral venous channels in and around a previously thrombosed portal vein. Collaterals can have intrahepatic extensions as well. The process of cavernous transformation can occur from one to 3 weeks to several months after portal venous thrombosis 1.
Among adults, the important causes of portal cavernoma are pancreatitis, pancreatic carcinoma, alcoholic cirrhosis, and hepatoma. Additionally, hypercoagulable states, inflammatory diseases of the abdominal cavity, severe dehydration, and shock can also lead to this condition 2. Symptoms of acute portal vein thrombosis include abdominal pain and fever, which may often go unnoticed.
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