Splenic, portal, and superior mesenteric vein confluens at EUS

Abstract

Endosonographers have developed descriptive terms that aid in the recognition of important vascular structures during EUS. Examples include “whale's tail” to described the celiac axis and its hepatic and splenic artery branches, as well as the “club sign” for the splenic—portal confluence. In a patient with carcinoma of the head of the pancreas undergoing staging EUS, the confluence of the splenic vein, portal vein, and a portion of the superior mesenteric vein was examined (A). The confluence had a shape reminiscent of an animal, specifically a seal.