Which vessel is most likely to display hepatofugal flow in the presence of portal hypertension?

The coronary vein (left gastric vein) is a common collateral pathway in portal hypertension. It often becomes dilated and may demonstrate hepatofugal (reversed) flow as blood diverts from the high-pressure portal system into systemic collaterals.

According to Zwiebel’s Introduction to Vascular Ultrasound:

“The left gastric (coronary) vein is a frequent site of hepatofugal flow in portal hypertension, reflecting collateral development.”