Passive hepatic congestion

Case contributed by Heba Abdelmonem
Diagnosis almost certain

Presentation

Abdominal pain. Background of hepatitis C.

Patient Data

Gender: Male
ct

Enlarged cardiac size with an abnormal filling of the inferior vena cava and hepatic veins in the arterial phase. The liver is cirrhotic, the spleen is enlarged, there is a mild amount of ascites, a small left pleural effusion is present, and there is edema of the subcutaneous fat.

Case Discussion

In a patient with diminished right-sided cardiac output or high right atrial pressure, once the contrast material is injected there is reflux of contrast material into the inferior vena cava and hepatic veins. This is one of the radiographic features of passive hepatic congestion.

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