Portal cavernoma caused by a calcified hydatid cyst of the liver (case report)

A portal cavernoma is a network of porto–porto collateral dilated tortuous veins lying within the hepatoduodenal ligament, which develops as a sequel to portal vein obstruction. This can be the result of extra-hepatic portal vein obstruction from local extrinsic occlusion, or by a prothrombotic disorder, or both. A 56-year-old woman presented with right upper quadrant abdominal pain. Examination and investigations revealed the presence of gallstones, a cavernous portal vein, several calcified hydatid cysts within the liver, grade III haemorrhoids, but no oesophageal varicosities. She had no previous abdominal surgery, and had normal full laboratory workup, including inflammatory markers, clotting analyses, and thrombophilia screen. At open surgery it became apparent that the portal cavernoma had been caused by local pressure from a calcified hydatid cyst of the caudate lobe of the liver. To the best of our knowledge, this is the first report of portal cavernoma caused by a hydatid cyst of the liver.