A female, 24 years of age, with no past history of significant liver disease presented to the liver clinic with progressively increasing subcutaneous nodules on the abdominal wall for the last 6 years. Physical examination revealed massive splenomegaly with multiple dilated tortuous veins on her abdominal wall with umbilical hernia (Fig. 1). Liver function tests were normal and gastroscopy showed grade II oesophageal varices. Subsequently, magnetic resonance imaging (MRI) of the abdomen with venography confirmed the diagnosis of noncirrhotic portal fibrosis. The coronal maximum-intensity projection MR venogram image (Fig. 2) showed a normal liver with a grossly dilated splenoportal axis as well as intrahepatic portal vein, along with splenomegaly and no free fluid. Axial flow-sensitive sequences showed a dilated paraumbilical vein with anterior abdominal wall collaterals.
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