Portal Hypertensive Cholangiopathy, Which Masquerades as an Acute Portal Vein Thrombosis

Kamila I. Cisak, Thanila A. Macedo, Shannon P. Sheedy, Patrick S. Kamath, Aneel A. Ashrani

Research output: Contribution to journalArticlepeer-review


Portal hypertensive cholangiopathy is a rare complication of extrahepatic portal vein obstruction and portal cavernoma. It is usually asymptomatic but may be associated with jaundice, biliary colic, and fever. Abdominal sonography and Doppler are ideal initial diagnostic modalities, followed by magnetic resonance cholangiopancreatography or endoscopic retrograde cholangiopancreatography. These imaging modalities are important if an intervention is planned for the management of portal hypertension and for relieving biliary obstruction. If computed tomography (CT) is performed in isolation, it may be challenging to distinguish this entity from acute on chronic portal vein thrombosis. The diagnostic results should be interpreted cautiously. This case report of an abdomen CT performed on a patient with a history of portal vein thrombosis masqueraded as an acute on chronic portal vein thrombosis with cavernous collaterals. Doppler confirmed the diagnosis of portal hypertensive cholangiopathy. Correlation with clinical symptoms and Doppler may be necessary to distinguish portal hypertensive cholangiopathy from acute portal vein thrombus.

Original languageEnglish (US)
Pages (from-to)182-185
Number of pages4
JournalJournal of Diagnostic Medical Sonography
Issue number2
StatePublished - Mar 1 2020


  • and cirrhosis
  • portal biliopathy
  • portal cavernoma–associated cholangiopathy
  • portal hypertensive cholangiopathy
  • portal vein thrombosis
  • pseudosclerosing cholangitis

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging


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