Duodenal variceal bleeding with large SPSS treated with transjugular intrahepatic portosystemic shunt and embolization: A case report

Figure 1 Portal vein angiography image showing hepatopetal flow through transjugular intrahepatic portosystemic shunt (blue arrow) with no filling of varices.

Figure 2 Endoscopic image showing active oozing of fresh blood (yellow arrow) from the ectopic varix in the fourth portion of the duodenum.

Figure 3 Angiographic image showing filling defect in the transjugular intrahepatic portosystemic shunt and the portal vein (yellow arrow) with portosystemic shunting to left renal vein (blue arrow).

Figure 4 Angiographic image showing a large mesenterico-gonadal venous shunt (blue arrow) draining into the inferior vena cava (yellow arrow) via the left renal vein (orange arrow).

Figure 5 Angiographic image of the portal vein showing the restoration of hepatopetal flow through the transjugular intrahepatic portosystemic shunt after the portosystemic shunt was embolized (yellow arrow).