Cavernous transformation of the portal vein may develop in a patient with portal vein thrombosis.
After portal vein thrombosis there is an attempt to form portoportal collateral veins in and around the portal vein. Eventually this can become a sponge-like, tangled mass of vessels around the portal vein. Some collaterals may develop around the bile ducts (pericholedochal).
The collaterals may result in a cholangiopathy related to:
(1) compression on adjacent bile ducts
(2) reduced blood flow to bile ducts potentially causing ischemia
(3) develop into varices
The collaterals may be large and dense enough to form a pseudotumor which needs to be differentiated from malignancies. Color Doppler imaging will show venous flow, indicating that the mass is composed of blood vessels.
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