case_images: PMC5960554_01
case_images: Hemobilia from a ruptured periampullary varix seen during an endoscopic retrograde cholangiopancreatography (ERCP).
case_images: CRIGM2018-4643695.001.jpg
case_images: PMC5960554_01_CRIGM2018-4643695.001.jpg
case_images: fig1
case_images: During the procedure, she developed active hemobilia (Figure 1) from a newly discovered periampullary varix (Figure 2).
case_images: A duodenal varix (blue arrow) seen in the periampullary region on retroflexion during endoscopic retrograde cholangiopancreatography (ERCP).
case_images: CRIGM2018-4643695.002.jpg
case_images: PMC5960554_01_CRIGM2018-4643695.002.jpg
case_images: fig2
case_images: During the procedure, she developed active hemobilia (Figure 1) from a newly discovered periampullary varix (Figure 2).
case_images: Intraoperative photo demonstrating the mesocaval bypass. An 8 mm ringed polytetrafluoroethylene (PTFE) graft was used to shunt blood flow from the proximal superior mesenteric vein (SMV) to the infrarenal IVC.
case_images: CRIGM2018-4643695.003.jpg
case_images: PMC5960554_01_CRIGM2018-4643695.003.jpg
case_images: fig3
case_images: Due to ongoing bleeding that required activation of a massive transfusion protocol, an exploratory laparotomy was performed with emergent mesocaval shunt placement (Figures 3 and 4).
case_images: Coronal view on computed tomography showing the mesocaval shunt (yellow arrow) originating from the SMV and inserting into the infrarenal IVC.
case_images: CRIGM2018-4643695.004.jpg
case_images: PMC5960554_01_CRIGM2018-4643695.004.jpg
case_images: fig4
case_images: Due to ongoing bleeding that required activation of a massive transfusion protocol, an exploratory laparotomy was performed with emergent mesocaval shunt placement (Figures 3 and 4).