Portal Vein Thrombosis and Cavernoma Formation in a Patient With Small Vessel Vasculitis

Abstract

Caput medusa or palm tree sign refers to dilated tortuous paraumbilical veins acting as portosystemic shunt in patients with portal vein thrombosis (PVT). We present an asymptomatic male patient who was diagnosed to have chronic PVT with cavernoma formation. His initial presentation was acute exacerbation of chronic obstructive lung disease. He was known to have small vessel vasculitis resulting in ischemic bowel resection. Bowel ischemia and surgical intervention are predisposing factors of PVT which is underdiagnosed clinically and when diagnosed, is diagnosed with delay. Early diagnosis has a good prognosis and can potentially avert morbidity.