INTRODUCTION
Cavernous transformation of the portal vein (CTPV) also known as portal cavernoma is a very rare condition of the liver which is usually characterized by the formation of multiple tortuous tiny blood vessels within and around a portal vein which has been partially or completely occluded by a thrombus 1–3.
Liver cirrhosis, hepatoma, splenectomy, liver transplant and pancreatitis are known causes of portal vein thrombosis that subsequently leads to CTPV in adults 1. However, CTPV have been mostly recorded in individuals with long-term thrombosis of the portal vein without evidence of primary liver disease1–3. Cases of CTPV have also been recorded in individuals with hematological diseases 4 and those with primary systemic vascular abnormalities which have resulted in chronic portal vein thrombosis 1,2,5.
The initial diagnosis of CTPV by clinicians may be challenging due to its diverse causes and clinical presentations 4,6. Common clinical manifestations are however those associated with portal hypertension as a result of chronic portal vein thrombosis; such as upper gastrointestinal bleeding (secondary to esophageal varices), anemia, splenomegaly, and ascites 3.
Abdominal Duplex Ultrasonography is a useful first-line imaging tool for both adult and pediatric patients with clinical presentations pointing towards the suspicion of liver disease or portal hypertension; because it allows for examination of abdominal organs and their vascular architecture in a real-time, efficient and safe manner7. Computed Tomography Angiography (CTA) and Magnetic Resonance Angiography (MRA) may be used for the confirmation of CTPV when an initial diagnosis is made with ultrasonography.
We therefore report on a case of a 22-year-old male in whom a diagnosis of cavernous transformation of the portal vein was made with Duplex ultrasonography who presented clinically with anemia and hematemesis.