PMC5894322_01
(A and B) Hepatic venous phase contrast CT coronal and axial images show subjective widening of the interlobal fissure of the liver
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F1
The indication of LB was a suspicion of parenchymal liver disease, as suggested by the widening of inter-lobar fissure of liver on contrast-enhanced computed tomography (CT) examination [Figure 1A and B], which also showed normal portal veins [Figure 2A and B].
(A and B) Note that the pre-biopsy CT scan imagesinportal venous phase (maximum intensity projection, coronal and axial images) show normal portal vein contrast opacification
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F2
The indication of LB was a suspicion of parenchymal liver disease, as suggested by the widening of inter-lobar fissure of liver on contrast-enhanced computed tomography (CT) examination [Figure 1A and B], which also showed normal portal veins [Figure 2A and B].
(A) USG image showing echogenic thrombus in the right portal vein(arrow) with absence of flow on color Doppler. (B and C) Coronal and axial MIP contrast-enhanced image shows absent contrast filling of the right portal system. (D) Portovenogram image from DSA shows nonopacification of the right portal system with irregular filling defects in the right portal vein
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F3
Ultrasound of the abdomen revealed echogenic thrombus completely occluding the right portal vein [Figure 3A]. Contrast-enhanced CT scan of upper abdomen confirmed right portal vein occlusion [Figure 3B and C]. Digital subtraction angiogram (DSA) of the portal system was obtained which also confirmed the right portal vein occlusion [Figure 3D].
(A and B) Portal venogram after thrombolysis showing restoration of blood flow in the right portal system
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F4
Repeat angiogram next day showed restoration of the blood flow in the right portal vein [Figure 4A and B].