Male, 71 years old.
History of enolic liver cirrhosis, gastrointestinal bleeding due to esophageal varices, recanalized portal vein thrombosis, percutaneous intrahepatic portosystemic shunt (IPPD) and portal cavernomatosis, admission due to abdominal pain
Endoscopic retrograde cholangiopancreatography is requested, revealing an irregular extrahepatic gallbladder, with stenosis and dilatations. Several clots are extracted with a balloon, and some differential diagnosis cholangitis persists.
A computed tomography scan showed a non-permeable IPPP and signs of portal hypertension.
Upon discharge, an echocardioscope was performed, showing prominent peripleural varices, collateral circulation, periportal and periportal, vascular varices, varices in the superior vena cava and collateral circulation in the wall.
