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A 17-year-old man was referred with a history of abdominal pain of several years duration. Physical examination was normal with normal hepatic-biliary enzyme levels and slight liver disfunction with aspartate… Click to show full abstract
A 17-year-old man was referred with a history of abdominal pain of several years duration. Physical examination was normal with normal hepatic-biliary enzyme levels and slight liver disfunction with aspartate aminotransferase/alanine aminotransferase of 33/57 IU/L. During contrast-enhanced abdominal computed tomography (CT), the trunk of the portal vein could not be identified (Picture 1, arrow). Based on the findings of angiography and CT during arterial portography (CTAP), extrahepatic portal vein obstruction was diagnosed. The blood flow from the splenic vein flowed backwards into the superior mesenteric vein (SMV); subsequently, the SMV blood flowed into the gastrocolic trunk and then into the intrahepatic portal vein (Picture 2). According to the 3D CT with CTAP data, the trunk of the por-
Journal Title: Internal Medicine
Year Published: 2019
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