In this Discovery Clinical Pathologic Conference (CPC), Dr. Karla Criner, Resident, Department of Medicine, presents the case of a previously healthy 18-year old male with a five month history of abdominal pain and growing distension. Dr. Courtney Miller-Chism, Assistant Professor, Department of Medicine, Section of Hematology-Oncology at Baylor College of Medicine, serves as the faculty discussant. She reviews the anatomy and physiology of the hepatic portal system and then develops a differential diagnosis to explain the patient’s ascites. 

As part of the Discovery CPC, Dr. Miller-Chism requests laboratory and imaging studies and explains her rationale for each request. She evaluates the lab results in the context of the patient’s history and physical exam findings.

Dr. Dhairyasheel Patel, Resident, Department of Radiology at Baylor College of Medicine, discusses the contrast-enhanced CT scan and abdominal ultrasound performed on the patient. He compares the patient’s imaging with normal imaging and highlights the relevant findings.