PMC5736957_01
Ultrasonography showed dilated and obstructed portal vein
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F1
An abdominal ultrasound demonstrated mild hepatomegaly with normal echo-texture, mild splenomegaly and the presence of a dilated and obstructed portal vein (Fig. 1).
Computed tomography scan shows an enlarged portal vein with multiple linear filling defects extending into the main portal vein
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F2
This finding was further confirmed with a computed tomography (CT) scan, which showed an enlarged portal vein (20 mm), with multiple linear filling defects extending into the main portal vein and both the branches with necrosis of segment III of the left lobe of liver (Fig. 2).
Endoscopy revealed four columns of grade III nonbleeding esophageal varices
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F3
In light of the finding of PVT, the patient underwent esophagogastroduodenoscopy, which revealed four columns of grade III nonbleeding esophageal varices in the distal esophagus along with fundal gastropathy (esophagogastric varices, type 1) (Fig. 3).
A liver biopsy showed no evidence of cirrhosis
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F4
A liver biopsy showed no evidence of cirrhosis (Fig. 4).