Generic placeholder image

Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Case Report

Pericholecystic Varices as the Predominant Manifestation in Cryptogenic Portal Hypertension: A Case Report

Author(s): Meng Tong, Yanli Gao, Feiyu Jia and Jinghua Liu*

Volume 20, 2024

Published on: 25 May, 2023

Article ID: e100423215577 Pages: 4

DOI: 10.2174/1573405620666230410085206

Price: $65

Abstract

Background: Portal hypertension has various manifestations, and varices are a common manifestation. Varices can appear in any vein in the body associated with the portal venous system.

Case Presentation: Herein, we report a case of portal hypertension with gallbladder varices as the main manifestation, which was confirmed by abdominal contrastenhanced CT with three-dimensional reconstruction and color Doppler ultrasonography. The patient had concomitant liver cirrhosis and portal vein thrombosis. Various auxiliary examinations and biochemical indicators of the patient confirmed liver cirrhosis, portal vein thrombosis, and portal hypertension, all of which were mild and did not reach the decompensation stage.

Conclusion: As illustrated by this case, when there is an embolism in certain parts of the portal system, portal hypertension can appear during the compensatory period and transition into severe varices in the thrombotic part during the de-compensatory period.

[1]
Li T, Yang Z. Research progress of vasculopathy in portal hypertension. World J Gastroenterol 2005; 11(39): 6079-84.
[http://dx.doi.org/10.3748/wjg.v11.i39.6079] [PMID: 16273630]
[2]
Tacchella G, Gjermeni O, Crinó SF, Gabbrielli A, Martinelli N. Portal hypertensive biliopathy and bile duct varices presenting as jaundice. Endoscopy 2021; 53(12): E442-3.
[http://dx.doi.org/10.1055/a-1337-1994] [PMID: 33506471]
[3]
Almadi MA, Almessabi A, Wong P, Ghali PM, Barkun A. Ectopic varices. Gastrointest Endosc 2011; 74(2): 380-8.
[http://dx.doi.org/10.1016/j.gie.2011.03.1177] [PMID: 21612777]
[4]
Chawla Y, Dilawari JB, Katariya S. Gallbladder varices in portal vein thrombosis. AJR Am J Roentgenol 1994; 162(3): 643-5.
[http://dx.doi.org/10.2214/ajr.162.3.8109513] [PMID: 8109513]
[5]
Bandali MF, Mirakhur A, Lee EW, et al. Portal hypertension: Imaging of portosystemic collateral pathways and associated image-guided therapy. World J Gastroenterol 2017; 23(10): 1735-46.
[http://dx.doi.org/10.3748/wjg.v23.i10.1735] [PMID: 28348478]
[6]
Gnerre J, Sun Y, Jedynak A, Gilet A. Case report: Gallbladder varices in a patient with portal vein thrombosis secondary to hepatocellular carcinoma. J Radiol Case Rep 2016; 10(5): 22-8.
[http://dx.doi.org/10.3941/jrcr.v10i5.2416] [PMID: 27761177]
[7]
Bosch J, Iwakiri Y. The portal hypertension syndrome: Etiology, classification, relevance, and animal models. Hepatol Int 2018; 12(S1): 1-10.
[http://dx.doi.org/10.1007/s12072-017-9827-9] [PMID: 29064029]
[8]
del Carmen MM, Barranco-Fragoso B, Uribe M, Méndez-Sánchez N. Portal vein thrombosis: What is new? Ann Hepatol 2015; 14(1): 20-7.
[http://dx.doi.org/10.1016/S1665-2681(19)30797-5] [PMID: 25536638]
[9]
Kovacs TOG, Jensen DM. Varices. Clin Liver Dis 2019; 23(4): 625-42.
[http://dx.doi.org/10.1016/j.cld.2019.07.005] [PMID: 31563215]
[10]
Cho KC, Patel YD, Wachsberg RH, Seeff J. Varices in portal hypertension: Evaluation with CT. Radiographics 1995; 15(3): 609-22.
[http://dx.doi.org/10.1148/radiographics.15.3.7624566] [PMID: 7624566]
[11]
Hui CL, Loo ZY. Vascular disorders of the gallbladder and bile ducts: Imaging findings. J Hepatobiliary Pancreat Sci 2021; 28(10): 825-36.
[http://dx.doi.org/10.1002/jhbp.930] [PMID: 33639040]
[12]
Intagliata NM, Caldwell SH, Tripodi A. Diagnosis, development, and treatment of portal vein thrombosis in patients with and without cirrhosis. Gastroenterology 2019; 156(6): 1582-99.
[http://dx.doi.org/10.1053/j.gastro.2019.01.265] [PMID: 30771355]
[13]
Gracia-Sancho J, Marrone G, Fernández-Iglesias A. Hepatic microcirculation and mechanisms of portal hypertension. Nat Rev Gastroenterol Hepatol 2019; 16(4): 221-34.
[http://dx.doi.org/10.1038/s41575-018-0097-3] [PMID: 30568278]
[14]
Turco L, Garcia-Tsao G. Portal hypertension. Clin Liver Dis 2019; 23(4): 573-87.
[http://dx.doi.org/10.1016/j.cld.2019.07.007] [PMID: 31563212]
[15]
Vizzutti F, Schepis F, Arena U, et al. Transjugular intrahepatic portosystemic shunt (TIPS): Current indications and strategies to improve the outcomes. Intern Emerg Med 2020; 15(1): 37-48.
[http://dx.doi.org/10.1007/s11739-019-02252-8] [PMID: 31919780]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy