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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Feb 27, 2026; 18(2): 115063
Published online Feb 27, 2026. doi: 10.4254/wjh.v18.i2.115063
Published online Feb 27, 2026. doi: 10.4254/wjh.v18.i2.115063
Diagnostic challenges of clinically significant portal hypertension in geriatric metabolic dysfunction-associated fatty liver disease: A case report
Femmy Nurul Akbar, Annisa Ayu Wardhani, Safira Rosiana Choirida, Hari Hendarto, Department of Internal Medicine, Faculty of Medicine, Universitas Islam Negeri Syarif Hidayatullah Jakarta, South Tangerang 15412, Banten, Indonesia
Nikko Darnindro, Ida Ayu Made Kshanti, Department of Internal Medicine, Fatmawati General Hospital, South Jakarta 12430, Jakarta, Indonesia
Shafa Nada Saphira, Griffith Ismed, Faculty of Medicine, Universitas Trisakti, Jakarta 11620, Jakarta, Indonesia
Syifa Mustika, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang 65145, Jawa Timur, Indonesia
Author contributions: Akbar FN, Choirida SR, Wardhani AA, Saphira SN, and Ismed G contributed to manuscript writing and editing, and data collection; Akbar FN, Darnindro N, and Kshanti IAM contributed to data analysis; Akbar FN, Darnindro N, Hendarto H, and Mustika S contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors have no potential conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Femmy Nurul Akbar, MD, Associate Professor, Department of Internal Medicine, Faculty of Medicine, Universitas Islam Negeri Syarif Hidayatullah Jakarta, Ir H. Juanda Street No. 95 Ciputat District, South Tangerang 15412, Banten, Indonesia.
Received: October 13, 2025
Revised: November 12, 2025
Accepted: December 16, 2025
Published online: February 27, 2026
Processing time: 128 Days and 22.5 Hours
Revised: November 12, 2025
Accepted: December 16, 2025
Published online: February 27, 2026
Processing time: 128 Days and 22.5 Hours
Core Tip
Core Tip: Metabolic dysfunction-associated fatty liver disease (MAFLD) is a chronic condition characterized by excess fat accumulation in the liver along with at least one cardiometabolic risk factor. MAFLD can progress silently to liver cirrhosis, often without noticeable symptoms, until clinically significant portal hypertension (CSPH) develops. CSPH can develop early in MAFLD, even before advanced hepatic fibrosis or cirrhosis sets in. We reported a case of a geriatric patient with MAFLD who had CSPH. Following variceal ligation and medical treatment, the patient showed notable improvement. However, diagnosing such cases in daily clinical practice remains quite challenging.