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The Conception Vessel (CV)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
Falciform ligament: A double layer of peritoneum, containing the ligamentum teres, paraumbilical veins, and fat. It courses from the umbilicus to the diaphragm at the tendinous portion of the abdominal aspect. The paraumbilical veins and the umbilical vein (which becomes vestigial in the adult to form the ligamentum teres) comprise an accessory portal system in communication with the systemic venous network.
Doppler in Portal Hypertension
Published in Swati Goyal, Essentials of Abdomino-Pelvic Sonography, 2018
Criteria of portal hypertension Increase in PV size >13 millimetersIncrease in portal pressure >11 millimeters HgLoss of normal respiratory/phasic variation in diameter of PV, SMVHepatoFUGAL flowDilated and tortuous SMV, SV, and HARecanalization of paraumbilical vein (Figure 34.2)Cavernous transformation—Multiple small vessels at the portaCollateral formation—Paraumbilical (caput medusae), epigastric, splenorenal, hemorrhoidal, paraesophageal, and gastroesophagealLow PV flow velocity <10 centimeters per second (low spectral trace)SplenomegalyFlow may be—Monophasic—Antegrade/retrogradeBiphasic—Retrograde during inspiration,antegrade during expirationPresence of thrombus—Acute (anechoic, may be overlooked without Doppler) and chronic (hyperechoic) (Figure 34.3)
Diffuse large B cell lymphoma primarily presenting as acute liver failure in a surviving patient
Published in Journal of Community Hospital Internal Medicine Perspectives, 2019
Jumpei Shibata, Shingo Kurahashi, Takehito Naito, Isamu Sugiura
Ultrasonography of the right-upper quadrant revealed an atrophied ‘potato liver’ with massive ascites. Contrast-enhanced computed tomography (CT) showed significant prominent atrophy of the liver with a mixed density area, suggesting fatty infiltration or hyperplasia and splenomegaly (Figure 1(a)). CT also revealed a dilated paraumbilical vein, indicating collateral circulation, and lymphadenopathy involving the peri-portal vein (Figure 1(b)). There was no sign of thrombosis or tumor embolus into the portal and hepatic veins, but an enlarged left cervical lymph node and slightly thickened gastric wall were observed.