Cystic Portal hypertension

Steenbergen, W. Dilatation of the cystic veins in portal hypertension sonographic demonstration. Radiology 1985 154 187-189... 

Di Sant Agnese, P. A., and Blanc, W. A., A distinctive type of biliary cirrhosis of the liver associated with cystic fibrosis of the pancreas. Recognition through signs of portal hypertension. Pediatrics 18, 387-409 (1956). 

Esophageal varices in children are a manifestation of portal hypertension that causes hepatofugal flow through esophageal collateral veins to drain into the superior vena cava. The most common children s diseases that cause portal hypertension include umhilical venous catheterization, biliary atresia, alpha-1 antitrypsin deficiency, autosomal recessive polycystic renal disease and cystic fibrosis. 

On US a choledochal cyst will be seen as a cystic lesion with a thin wall, well defined borders, and echogenic material inside the cyst that corresponds to biliary sludge. However, it is important in the US evaluation to determine if the cyst is really a dilated choledochus, if the intrahepatic ducts are compromised, and if there is portal hypertension. As US has shown a specificity of 97% for choledochal cysts, it is widely used as the first diagnostic tool (Gubernick et al. 2000 Teele and Share 1991). 

Considered the most common, the splenic artery aneurysm has been reported to comprise approximately 60% of all VAAs [1,2]. This entity affects females four times as often as males. Typically seen in multiparous women, this aneurysm has a high propensity to rupture in the third trimester of pregnancy [29]. Asymptomatic aneurysms can often be seen as round calcified masses in the left upper quadrant on plain films and computed tomography. This type of aneurysm has been associated with portal hypertension. Many causes exist and include pancreatitis, portal hypertension, endocarditis, cystic medial necrosis, iatrogenic, and collagen vascular diseases such as Ehlers-Danlos. 

---