28292056 Visualization

We report the case of a 68 Age - year Age - old Age female Sex with no History past History medical History history History , presented Clinical_event with an upper Biological_structure gastrointestinal Biological_structure bleeding Sign_symptom and pain Sign_symptom in left Biological_structure upper Biological_structure abdomen Biological_structure .
Physical Diagnostic_procedure examination Diagnostic_procedure found a splenomegaly Sign_symptom and signs of portosystemic Disease_disorder collateral Disease_disorder formation Disease_disorder including abdominal Biological_structure wall Biological_structure dilated Sign_symptom veins Sign_symptom and rectal Biological_structure haemorrhoids Sign_symptom .
No biological Sign_symptom abnormalities Sign_symptom were noted besides those due to hypersplenism Disease_disorder ( anaemia Sign_symptom and thrombocytopenia Sign_symptom ).
The patient underwent upper Biological_structure gastrointestinal Biological_structure endoscopy Diagnostic_procedure that showed stage Detailed_description III Detailed_description oesophageal Biological_structure varices Sign_symptom with portal Disease_disorder hypertensive Disease_disorder gastropathy Disease_disorder and red Sign_symptom signs Sign_symptom .
Ultrasonography Diagnostic_procedure revealed a fusiform Sign_symptom dilatation Sign_symptom of the portal Biological_structure bifurcation Biological_structure measuring 40 Distance mm Distance in diameter with dilated Detailed_description branches Detailed_description ; no signs Sign_symptom of Sign_symptom portal Sign_symptom thrombosis Sign_symptom were detected (Figure 1).
The portal Biological_structure Doppler Diagnostic_procedure study Diagnostic_procedure showed a normal Lab_value hepatopetal Lab_value flow Lab_value .
Other Sign_symptom signs Sign_symptom of Sign_symptom portal Sign_symptom hypertension Sign_symptom were found, including splenomegaly Sign_symptom , repermeation Sign_symptom of the umbilical Biological_structure vein Biological_structure and a splenorenal Biological_structure collateral Sign_symptom circulation Sign_symptom .
A complementary angio Biological_structure - CT Diagnostic_procedure allowed a better assessment of the portal system that contained some thin Sign_symptom calcifications Sign_symptom in the aneurysmal Biological_structure wall Biological_structure and the main Biological_structure portal Biological_structure trunk Biological_structure (Figure 2, Figure 3, Figure 4).
Other Sign_symptom signs Sign_symptom of Sign_symptom portal Sign_symptom hypertension Sign_symptom were noted such as oesophageal Biological_structure and gastric Biological_structure varices Sign_symptom , parietal Biological_structure collateral Sign_symptom circulation Sign_symptom associated to ultrasonography Coreference findings.
Liver Disease_disorder cirrhosis Disease_disorder was confirmed by transcient Diagnostic_procedure elastometry Diagnostic_procedure and biopsy Diagnostic_procedure .