Sunday 5 January 2014

What's the diagnosis?

Young man with new onset abdominal distension and right hypochondrial pain. CT scan of abdomen is shown.

(courtesy UpToDate)

2 comments:

  1. This is one of those instances where a picture speaks louder than a thousand words. The young man has Budd Chiari syndrome due to obstruction of the hepatic veins by thrombus. While the rest of the liver shows patchy mottling and atrophy, the caudate lobe stands out undiminished (large arrowhead) because it has a separate blood supply and drainage from the rest of the liver (veins from the caudate lobe drain directly into the IVC rather than through the hepatic veins). The dark areas (small arrows) indicate ascites, the large arrow points to retro-peritoneal varices, and the small arrowhead indicates the collapsed IVC.

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  2. .....well illustrated, nd explained...!!!

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