We'd like to understand how you use our websites in order to improve them. Register your interest. Nous rapportons deux observations de cavernome portal. Rupture of esophageal varices due to schistosoma induced portal hypertension remains the major etiology of non ulcer gastrointestinal bleeding in Madagascar.
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Cavernous transformation of the portal vein CTPV is a sequela of portal vein thrombosis and is the replacement of the normal single channel portal vein with numerous tortuous venous channels. For a discussion of demographics and presentation, please refer to the article on portal vein thrombosis. Following thrombosis, the portal vein may or may not re-canalize. Re-canalization is seen more frequently in patients without cirrhosis or disease of the liver leading to inherently increased resistance to portal flow.
In patients whose portal vein does not recanalize, or only partially re-canalizes, collateral veins thought to be paracholedochal veins dilate and become serpiginous. These vessels drain variably into the left and right portal veins or more distally into the liver.
Additional communications can also be identified with the pericholecystic veins. Cavernous transformation of the portal vein is most of the times inefficient in guaranteeing adequate portal vein inflow to the liver parenchyma far from the hilum and, therefore, is associated with an increased hepatic arterial flow to those peripheral liver segments. These changes lead to central liver hypertrophy and peripheral liver atrophy 8. In addition to direct visualization of the dilated vessels, the resultant portal hypertension results in other frequent changes: see portal hypertension.
Additionally, there are changes in liver shape which are somewhat different to those seen in cirrhosis 2. Typically these changes are:.
Doppler examination can be carried out at the same time to evaluate for portal hypertension. Cavernous transformation appears as numerous tortuous vessels occupying the portal vein bed. Flow is generally hepatopetal and continuous with little if any respiratory or cardiac variation 4.
MRI is also a proven method for imaging the portal venous system and may be used as a complementary or alternative modality to CT.
MRI is usually reserved to clarify associated benign hepatocellular nodules that may be seen in up to a fifth of the patients, particularly the focal nodular hyperplasia -like lesions 8. Whereas portal hypertension can in some cases be treated with TIPS , the absence of normal portal circulation usually makes this impossible. Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Updating… Please wait. Unable to process the form. Check for errors and try again.
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Edit article Share article View revision history Report problem with Article. URL of Article. Article information. Systems: Hepatobiliary , Vascular. Tags: liver , portal vein. Support Radiopaedia and see fewer ads. Cases and figures. Case 1 Case 1. Case 2 Case 2. Case 3 Case 3. Case 4 Case 4. Case 5 Case 5. Case 9 Case 9. Case 10 Case Case in a pediatric patient Case in a pediatric patient. Case color Doppler cine loop of portal cavernoma Case color Doppler cine loop of portal cavernoma.
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Le cavernome portal : cause rare d’hémorragie digestive et d’ictère
Portal cavernoma in children revealed by gastrointestinal haemorrhage: about a case. Portal cavernoma is a venous vascular anomaly characterized by the formation of a network of veins whose caliber is increased and carrying portal blood. It is due to a thrombotic and always chronic occlusion of the extra-hepatic portal venous system. This is one of the most common causes of portal hypertension in children. Its severity is mainly associated with an high risk of gastrointestinal haemorrhage. Very few cases have been described mainly in African literature.