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Editor’s quiz: GI snapshot
A case of jaundice in portal hypertension
  1. Shivali Vaibhav Kashikar1,
  2. Tony C K Tham2,
  3. Money Bansal1,
  4. Bhushan Lakhkar1,
  5. Gaurav Prakash Manikpure3
  1. 1Radio-diagnosis, Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha, Maharashtra, India
  2. 2Division of Gastroenterology, Ulster Hospital, Dundonald, Belfast, UK
  3. 3Division of Hepatology/Gastroenterology, Royal Victoria Hospital, Belfast, UK
  1. Correspondence to Dr Shivali Vaibhav Kashikar, Radio-diagnosis, Jawaharlal Nehru Medical College, Sawangi Meghe, Behind Maganwadi, Ram Nagar, Sarvodaya Plots, Wardha 442001, Maharashtra, India; shivalikashikar{at}gmail.com

https://doi.org/10.1136/gutjnl-2012-303817

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    A 38-year-old woman, diagnosed with portal hypertension 8 months back, presented with painless jaundice. Her synthetic liver function was normal and serology was negative for hepatitis virus. Liver function tests showed total serum bilirubin 321 mmol/l, serum alanine aminotransferase 59 IU/l, aspartate aminotransferase 80 IU/l, γ-glutamyltransferase 114 IU/l and serum alkaline phosphatase 296 IU/l. CT of the abdomen showed hepatosplenomegaly, ascites and intrahepatic and extrahepatic biliary ductal dilatation (figure 1). The common bile duct showed smooth tapering distally without any mass. The main portal vein was replaced by a large cavernoma and multiple collaterals were seen at systemic-portal sites. This portal cavernoma …

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    Footnotes

    • Contributors SVK, MB and BL diagnosed and followed up the case. SVK drafted the article and was helped in its improvement by GPM and TCKT.

    • Competing interests None.

    • Patient consent Obtained.

    • Ethics approval Institutional ethics committee.

    • Provenance and peer review Not commissioned; internally peer reviewed.