case_images: PMC7475747_01
case_images: Cross-sectional imaging demonstrating (a) cavernous transformation (blue arrow) and (b) splenorenal shunting (orange arrow) with large upper abdominal varices used for alternate portal inflow (green arrow).
case_images: CRIT2020-8875196.001.jpg
case_images: PMC7475747_01_CRIT2020-8875196.001.jpg
case_images: fig1
case_images: Contrast enhanced CT demonstrated complete PVT with cavernous transformation (Figure 1(a)) and clot extending into the distal SMV. A large splenorenal shunt and large upper abdominal varices were noted (Figure 1(b)).
case_images: PMC7475747_02
case_images: MRI, intraoperative, and ultrasound imaging demonstrating (a) extensive esophageal varices (blue arrow), (b) a large perigastric varix used for portal inflow (green arrow), (c) the clamped varix, (d) an ileac vein graft anastomosed to the varix, (e) the porta postimplantation with varicoportal inflow and the overlying hepatic artery, and (f) Doppler imaging of the varicoportal inflow.
case_images: CRIT2020-8875196.002.jpg
case_images: PMC7475747_02_CRIT2020-8875196.002.jpg
case_images: fig2
case_images: Preoperative imaging revealed cavernous transformation with numerous portal venous collaterals most prominent in the paraesophageal (Figure 2(a)) and perigastric regions (Figure 2(b)). Variant portal inflow was created by joining an ileac vein graft to a large perigastric varix (Figures 2(c)-2(f)).