1) We reported on several ultrasonographic findings observed in a patient with widespread intrahepatic and extrahepatic portal vein thrombosis (PVT), which was later confirmed by autopsy. 2) Ultrasonography (US) revealed echogenic vascular structures (A), corresponding to the intrahepatic portal branches, were surrounded by a hypoechoic zone (B). Thin tubular structures and/or a narrow lumen (C) were also noted in the echogenic area and low-level echoes (D) were observed in the portal trunk (PT).
3) These ultrasonographic findings were more clearly demonstrated by ultrasonograms of the liver during the autopsy. Several large branches of the intrahepatic portal vein were partially obstructed (40 ˞ 60%) by relatively organized thrombi, and both the PT and umbilical portion were almost completely obstructed by relatively fresh thrombi (d).
4) A microscopic examination revealed organized thrombi (a) and recanalization (c) in the large portal branches. Widened periportal connective tissue with edema and abundant small lymphatic vessel-like structures (b) were also noted
5) A possible connection between ultrasonographic findings (A),(B),(C) and(D) and pathological findings (a), (b), (c) and (d) respectively, is strongly suggested by this study.