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Caudate lobe enlargement is often present. The majority of patients have a slower-onset form of Budd–Chiari syndrome. This can be painless. A system of venous collaterals may form around the occlusion which may be seen on imaging as a "spider's web". Patients may progress to cirrhosis and show signs of liver failure. [3]
The caudate process is a small elevation of the hepatic substance extending obliquely and laterally, from the lower extremity of the caudate lobe to the undersurface of the right lobe. The caudate lobe has a complex blood supply system. It derives its arterial supply from the caudate arteries, which arise from the right, left, and middle ...
Caudate lobe hypertrophy on ultrasound due to cirrhosis Hepatofugal (non-forward) flow in portal vein. The diagnosis of cirrhosis in an individual is based on multiple factors. [32] Cirrhosis may be suspected from laboratory findings, physical exam, and the person's medical history. Imaging is generally obtained to evaluate the liver. [32]
In the axial plane, the caudate lobe should normally have a cross-section of less than 0.55 of the rest of the liver. [ 2 ] Other ultrasound studies have suggested hepatomegaly as being defined as a longitudinal axis > 15.5 cm at the hepatic midline, or > 16.0 cm at the midclavicular line .
The sign is similar in mechanism but distinct in significance from the hot caudate sign, in which the caudate lobe of the liver shows preferential enhancement or radiotracer accumulation with hepatic vein occlusion in Budd Chiari syndrome.
The right vertical limb of the "H" defines the left and right functional lobes, while the left vertical limb of the "H" defines the right and left anatomical lobes. The horizontal line between the vertical limbs of the "H" represents the porta hepatis. The quadrate and caudate lobe lie superior and inferior to this line respectively.
Pretty sure these photos are what you'd find if you looked up "STUNS" in the dictionary (at least it should be, take note Merriam-Webster). Gilbert Flores - Getty Images Jon Kopaloff - Getty Images
A less common, but more serious complication, is hepatic ischemia causing acute liver failure. While healthy livers are predominantly oxygenated by portal blood supply, long-standing portal hypertension results in compensatory hypertrophy of and increased reliance on the hepatic artery for oxygenation.