• Bing Pan, ShaoCheng Lyu, and Qiang He.
• Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
• Medicine (Baltimore). 2022 Oct 7; 101 (40): e30766e30766.

RationaleThe incidence of portal and mesenteric venous calcifications in patients with cirrhosis has rarely been reported. It is also very difficult to determine the vascular lesions in preoperative imaging examination. The liver cirrhosis patients associated with portal venous calcification have high postoperative complications and mortality, but poor prognosis.Patient ConcernsWe present a patient (45-year-old male), who was admitted to the hospital with liver cirrhosis and portal hypertension associated symptoms.DiagnosesAbdominal imaging computed tomography confirmed the presence of calcification in the portal vein system.InterventionsThe patient underwent allogeneic liver transplantation.OutcomesThe patient died 2 days after liver transplantation.LessonsCalcification in the portal vein system is extremely rare, and always occurs in patients with long-standing liver cirrhosis with portal hypertension gastroesophageal varices and splenomegaly. The presence of portal vein calcification on computed tomography may be a sign of portal vein thrombosis, which may result in a difficult transplantation, and poor prognosis.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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