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Left-Sided Portal Hypertension (Liver & Porto-Hepatic Scintigraphy / Contributed by Indonesia)

Left-Sided Portal Hypertension (Liver & Porto-Hepatic Scintigraphy / Contributed by Indonesia)
Hussein Kartamihardja, MD
Universitas Padjadjaran, E-Learning in Nuclear Medicine An Electronic Atlas of Interesting Nuclear Medicine Cases
Bahasa Inggris
Universitas Padjadjaran, E-Learning in Nuclear Medicine An Electronic Atlas of Interesting Nuclear Medicine Cases
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HISTORY A 14-year-old girl presented with upper gastrointestinal bleeding and melena. Physical examination revealed hepatomegaly (3 cmunder the costal arch) and splenomegaly of Schuffner 2. FINDINGS Liver Scintigraphy. Liver scintigraphy using 99mTc sulfur colloid (Figures 1A and 1B) showed enlargement of the liver with relatively normal tracer uptake and distribution. Scan also showed enlargement of the spleen with increased tracer uptake. Hepato-Porto Scintigraphy. Dynamic hepatoporto scintigraphy using 5mCi of Tc pertechnetate (Figures 2A and 2B) per-rectum was done and followed by serial static imaging for 120 minutes. These images showed the flow of radiopharmaceutical from rectum to the liver and stopped at the porta hepatis and then turned to caudally left side. Conclusion based on both scintigraphy is left sided portal hypertension without sign of hepatic cirrhosis

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