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A total of 30 patients with portal hypertension examined by computed tomography (CT) was reviewed for identification of portosystemic collaterals and other changes in the portal venous system. CT demonstrated esophageal varices in 18 of 25 patients shown to have varices by other methods. Mediastinal venous masses secondary to a dilated azygos system and paraesophageal veins were also recognized by CT. Other collaterals, such as gastrorenal, paraumbilical pathways, and caput medusa, could be seen and instances of splenic vein dilatation and portal vein aneurysm were encountered. CT in portal hypertension can be useful in establishing that mass lesions may in fact be dilated veins.
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