Portal vein calcification and associated biliary stricture in idiopathic portal hypertension (Banti's syndrome)

We present a case of dense portal vein calcification with secondary extrahepatic biliary stricture and cholangitis in an adult patient diagnosed with idiopathic portal hypertension at age three, Biliary ductal dilation proximal to echogenic shadowing foci near the porta hepatis mimicked choledocholithiasis on sonographic examination. Portal vein calcification and biliary stricture from portal venopathy each represent rare findings. The obstruction was successfully managed with biliary stenting.