an_improved_meIn general though, i don't think you need to know that... I think the important things are that:
tells you there is widening of hepatic venules (which one can imagine is due to increased pressure)
tells you that hepatic wedge pressure (estimate of portal pressure) is 30; portal pressure should be less than 5.
therefore, elevated portal pressure in the absence of RA pressure indicates obstruction before the heart (in this case, budd chiari).
Compare that to cardiac cirrhosis, which would have increased RA pressures AND increased portal venous pressures.
+2020-07-17T01:09:34Z
an_improved_meShit, and finally, since there are only mild increases in billi, AlkPhos, AST/ALT, i think that rules out cirrhosis. +2020-07-17T01:10:22Z
an_improved_meAdd the fact that he doesn't have risk factors for cirrhosis (no drinking, smoking cigs, [would have loved to see a negative serology panel...], i think that also brings cirrhosis further down on your DDx+2020-07-17T01:11:54Z
an_improved_meAdd the fact that he doesn't have risk factors for cirrhosis (no drinking, smoking cigs, [would have loved to see a negative serology panel...], i think that also brings cirrhosis further down on your DDx+2020-07-17T01:11:57Z
submitted by shieldmaiden(8), 2020-07-15T23:08:21Z
How do the h/o renal cell carcinoma and removal of one kidney/adrenal correlate with occlusion of the hepatic vein?