DESCRIPTION

A 45-year-old man presented to us with a history of upper abdominal fullness, early satiety and decreased appetite. He also had a history of symp-toms suggestive of left-sided portal hypertension. CT scan (figure 1) demonstrated a large cystic lesion arising from the left lobe of the liver, com-pressing the stomach, splenic vein and left renal vein, and a left-sided varicocele. The varicocele may have been caused due to compression of the left renal vein (figures 2 and 3). The features suggestive of left-sided portal hyper-tension could be explained by pressure on the splenic vein. The extensive peri-gastric collaterals seen provided the evidence of left-sided portal hypertension (figure 4). Mechanical deformation o