Demographics:
54 years old, Female
Indication:
Nausea, vomiting
Findings
Lower chest
- Mild dependent atelectasis
- Calcified left lower lobe granuloma
- Scattered perifissural nodules and micronodules
Abdomen/Pelvis
- Enlargement of the main portal vein with internal low attenuation and surrounding fat stranding. This process extends diffusely throughout right and left portal vein branches as well as 2 cm into the splenic vein
- Enlargement of the SMV without definite internal hypoattenuation
- Surgical changes of sleeve gastrectomy (performed recently) without bowel obstruction
- Geographic hepatic hypoattenuation adjacent to the falciform ligament
- Small calcified gallstone without gallbladder distension, wall thickening, pericholecystic inflammatory changes, or biliary duct dilation
- 9 mm hypoattenuating lesion in the superior aspect of the spleen
- Heterogeneous low attenuation lesion measuring 1.5 cm in the interpolar left kidney
- Mild fat stranding in the small bowel mesentery
- Colonic diverticulosis
- Mild atherosclerotic calcification of the abdominal aorta and branch vessels without aneurysm
MSK
- No acute findings
Diagnosis
Portal vein thrombosis
Sample Report
Extensive portal vein thrombosis with extension into the splenic and right and left portal intrahepatic branches.
Small geographic area of hypoattenuation adjacent to the falciform ligament may relate to altered perfusion.
Surgical changes of sleeve gastrectomy without bowel obstruction, loculated intraabdominal collection, or pneumoperitoneum.
Heterogeneous solid lesion in the interpolar left kidney. Recommend nonemergent renal protocol CT or MRI for further evaluation.
Discussion