We described the case of a 56 year-old man with cirrhosis due to hemochromatosis and who had undergone a surgical terminolateral portocaval shunt 17 years previously. The patient was admitted for jaundice. Ultrasonography initially suggested multiple intrahepatic tubular structures, interpreted as enlarged intrahepatic bile ducts. Pulsed Doppler ultrasonography demonstrated that this spectral waveform corresponded to the intrahepatic extension of a diffuse portal cavernoma. Cavernomatous transformation of portal vein should be suspected when intrahepatic tubular structures are associated with long standing portal vein thrombosis.