Hepatobiliary and Pancreatic: An uncommon cause of portal hypertension.
(2022) Journal of gastroenterology and hepatology — Vol. 37, n° 10, p. 1843 (2022)
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- Abstract
- (en) A 42-year-old female patient was referred to our hepatology clinic after identification of Grade 2 esophageal varices at upper gastrointestinal endoscopy (Fig. 1a). Her medical history is remarkable for a laparotomy cholecystectomy in Brazil back in 2013. The body mass index is normal. On clinical examination, the abdomen is diffusely tender. The spleen is palpated. A right subcostal laparotomy scar is visible. Blood analysis showed isolated thrombocytopenia (platelet count 91 000/mm3) and mildly elevated transaminases (AST 37 UI/L, ALT 43 UI/L). There was no cholestasis nor prothrombin time prolongation. Abdominal ultrasound was remarkable for a slight elevation of hepatorenal index (suggestive of mild steatosis), normal liver contours (Fig. 1b), a splenomegaly (Fig. 1c), and mild ascites. Vibration-controlled transient elastography further confirmed slight steatosis (controlled attenuation parameter [CAP™] 221 dB/m) and excluded advanced fibrosis (elasticity [E] 5.5 kPa with a medium probe) (Fig. 1d). What is your diagnosis and what do you recommend?
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Binet, Q., Annet, L., Danse, E., Goffette, P., & Lanthier, N. (2022). Hepatobiliary and Pancreatic: An uncommon cause of portal hypertension. Journal of gastroenterology and hepatology, 37(10), 1843. https://doi.org/10.1111/jgh.15961 (Original work published 2022)