Demographics:
55 years old, Male
Indication:
Pancreatitis, negative sonographic Murphy sign
Findings
- Visualized pancreatic parenchyma is heterogeneous and hypoechoic
- Borderline dilation of the main pancreatic duct, which measures up to 3 mm in diameter
- Echogenic material within the main portal vein extending from the portosplenic confluence into the right and left portal veins
- No flow is demonstrated in left portal venous branches on Doppler imaging with decreased, bidirectional flow in the main and right portal veins
- Increased hepatic parenchymal echogenicity
- Round, hypoechoic lesion in the right hepatic lobe measuring 1.2 x 1.5 x 1.3 cm with posterior acoustic enhancement, compatible with a cyst
- Normal appearance of the gallbladder with no gallstones identified
- No intrahepatic or extrahepatic biliary duct dilation
- Normal appearance of the right kidney
Diagnosis
- Portal vein thrombosis
- Pancreatitis
Sample Report
Portal vein thrombosis extending from the portosplenic confluence into the right and left portal veins with occlusion of left portal venous branches.
Visualized pancreatic parenchyma is heterogeneous and hypoechoic, consistent with reported pancreatitis.
No ascites or peripancreatic collection identified, though CT could provide further evaluation.
Borderline dilation of the main pancreatic duct measuring up to 3 mm in diameter, which may relate to chronic pancreatitis. Although no obstructing lesion is visualized, CT could provide further evaluation.
Normal appearance of the gallbladder with no gallstones identified.
Increased hepatic parenchymal echogenicity, suggestive of steatosis.
Discussion
References