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A patient with cirrhosis and portal hypertension is referred for sonographic evaluation. A hypoechoic, tubular structure in the region of the the ligamentum teres is noted. Within this structure, pulsed-wave and color Doppler demonstrate blood flow exiting the liver. This finding most likely represents:

a) Budd-Chiari
b) A failed TIPS
c) esophageal varices
d) recanalization of the umbilical vein

User Jebbie
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1 Answer

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Final answer:

The tubular structure with exiting blood flow in a patient with cirrhosis and portal hypertension likely represents recanalized umbilical vein as a result of the body compensating for obstructed blood flow through the liver.

Step-by-step explanation:

The sonographic findings of a hypoechoic, tubular structure in the region of the ligamentum teres with blood flow exiting the liver observed in a patient with cirrhosis and portal hypertension most likely represents recanalization of the umbilical vein. In cirrhosis, the presence of scarring obstructs blood flow, resulting in portal hypertension. As a compensatory mechanism, the body may open or recanalize alternative pathways such as the umbilical vein to divert blood around the liver, bypassing the hepatic portal circulation. Other conditions like Budd-Chiari syndrome, a failed Transjugular Intrahepatic Portosystemic Shunt (TIPS), or esophageal varices do not typically present with this specific sonographic sign.

User Thandasoru
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