PMC4896106_01
40-year-old man with pancreatic carcinoma. CT shows pancreatic mass encasing portal venous confluence.
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There was main pancreatic ductal dilation, arterial encasement, and encasement of both the superior mesenteric and splenic veins with abrupt termination of venous flow near confluence with the portal vein and reconstitution of the portal vein via collaterals (Figure 1A). THADs were seen in the periphery of the right and left liver lobes (Figure 1B, Figure 1C).
PMC4896106_02
40-year-old man with pancreatic carcinoma. CT Image several centimeters cranial to Fig. 1A shows THAD of left lobe of the liver.
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On CT, a multiloculated, rim enhancing fluid collection measuring 14 x 11 x 23 cm was seen within the right abdomen, with venous compression at the confluence of the superior mesenteric and splenic veins (Figure 2A). A left lobar THAD was seen on the arterial phase (Figure 2B), and a replaced left hepatic artery from the left gastric artery was incidentally noted.
PMC4896106_03
40-year-old man with pancreatic carcinoma. Curved planar CT image of splanchnic venous system shows narrowing at portal venous confluence.
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A staging abdominal CT demonstrated a 3.2 x 2.4 cm nodal metastasis compressing the portal venous confluence (Figure 3A) and a THAD involving the caudate and left hepatic lobe (Figure 3B).
PMC4896106_04
20-year-old man with post-traumatic pancreatic pseudocyst . CT shows compression at portal confluence by cystic mass.
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A CT scan was performed and a 5 x 4 cm extrahepatic abscess was identified in the portocaval space, with mass effect on local structures including caudate lobe of the liver, and the SMV, SMA and portal vein (Figure 4A). A left lobe THAD was seen (Figure 4B).
PMC4896106_05
20-year-old man with post-traumatic pancreatic pseudocyst . Arterial phase CT shows THAD in the left lobe of the liver.
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There was compression of the superior mesenteric vein and splenic vein with flow preserved in the portal vein just beyond the confluence (Figure 5A). A THAD was evident in portions of the left hepatic lobe (Figure 5B).
PMC4896106_06
60-year-old man with lung cancer. CT shows external compression of the portal confluence by nodal metastases (arrow).
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Contrast-enhanced CT showed complete thrombosis of the main portal vein, left and right portal veins, with relatively increased perfusion of the periphery of the liver and decreased enhancement of the central portion of the liver (Figure 6A).
PMC4896106_07
60-year-old man with lung cancer. CT shows resultant THAD in left lobe of the liver.
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THAD within the peripheral subcapsular zones of the liver (Figure 7). There was no history of sclerosing cholangitis or evidence of Budd-Chiari syndrome to account for the caudate lobe enlargement.