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