[Esophageal varices and dyspnea. A clinicopathological conference report]

A young man who had moved from India to Finland was extensively examined for abdominal complaints. The findings included large esophageal varices, open portal vein and enlarged lymph nodes. The large spleen was excised. The diagnosis did not become clear from laboratory investigations. After ten years the patient was repeatedly examined to reveal the cause of esophageal varices and abdominal complaints. Autoimmune pancreatitis and cholangitis were suspected after 23 years from the initial symptoms. In the end, the most plausible explanation for the patient's mixed disease was tuberculosis. Sarcoidosis was another disease that came into question.