[Diagnosis of cavernomatous transformation of the portal vein]

In 10 patients at the age of 17 to 59 years the diagnosis of a cavernomatous transformation of the portal vein primarily was made by sonography and was confirmed by computer tomography and angiography, respectively. These findings were seen by chance when an abdominal ultrasound was performed in order to clarify splenomegaly or esophageal varices. The characteristics of the disease are the positive proof of a convoluted agglomeration of racemose venous structures that have replaced the normal single portal vein and signs of portal hypertension. The sonographic figures are so typical that ultrasound is the decisive procedure in its diagnosis and that direct or indirect splenoportography is not necessary. The present results show that clinical manifestations of cavernomatous transformation of the portal vein are delayed sometimes in to adolescence and that invasive diagnostic methods are only necessary when shunt operation is planned.