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A painful liver
  1. I Oliver1,
  2. J Lacueva1,
  3. R Calpena1,
  4. E Girona2
  1. 1Department of Pathology and Surgery, Elche University General Hospital, Elche (Alicante), Spain
  2. 2Department of Internal Medicine, Elche University General Hospital, Elche (Alicante), Spain
  1. Correspondence to:
    Professor I Oliver
    Camí de l’Almazara, #11, 03202, Elche (Alicante), Spain; israel.oliverumh.es

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Clinical presentation

A 62 year old woman was admitted to Elche University General Hospital for further evaluation of an intermittent right upper quadrant pain unrelated to meals or posture. She had previously been well with no history of liver disease, alcohol abuse, or abdominal trauma. On physical examination, there were no signs of chronic liver disease or portal hypertension. Results of laboratory studies, liver function tests, and ultrasound guided liver biopsy were also normal. Real time and colour Doppler ultrasonography showed an anechoic mass-like lesion at the porta hepatis with continuous non-pulsatile flow within the lesion. The gallbladder was normal with no gallstones visualized. Then, a helical computed tomography (CT) scan was performed.

Question

What does this investigation show (fig 1).

Figure 1

 Contrast computed tomography showing a high signal intensity mass over the hilum of the liver, suggesting an aneurysmal dilatation of the portal vein.

See page 943 for answer

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