Cavernous transformation of portal vein - a rare cause of massive hepatomegaly

ABSTRACT

There are very few reported cases of Cavernous Transformation of Portal Vein [CTPV] in adults. We present a case of 79 years old male who was found to have this complication due to portal vein thrombosis [PVT]. A 79 year old male with background history of JAK2 positive Myeloproliferative disorder [MPD] was referred with abnormal liver function tests. Patient was clinically well and asymptomatic. During initial workup for his abnormal LFTs, patient was noted to have enlarged caudate lobe of liver. Further abdominal imaging studies showed massively enlarged caudate lobe of liver with Cavernous Transformation of Portal Vein [CTPV], a very rare complication of portal venous thrombosis. Cavernous transformation of portal vein is a very rare cause of enlarged caudate lobe of liver. The management of CTPV is mainly symptomatic. Most of the patients are asymptomatic at presentation. Complications mostly occur due to portal hypertension which can be life threatening. There is no consensus on the management of Cavernous Transformation of portal vein itself. Patients with cavernous transformation of portal vein should be kept under regular follow up