PMC7762672_01
(a) Non-contrast-enhanced CT scan of the abdomen and pelvis showing splenomegaly with a craniocaudal length of 23 cm and portosystemic collaterals. (b) Endoscopic image of the stomach showing diffuse portal gastropathy. (c) Fluoroscopic image following TIPS placement (blue arrow) and coiling of the bleeding esophageal varix (red arrow).
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He underwent an abdominal CT scan to rule out any structural causes of his profound thrombocytopenia and was identified to have an enlarged spleen (Figure 1(a)) at age 20. On endoscopy, he had grade 3 varices which were actively bleeding, as well as diffuse portal gastropathy (Figure 1(b)). The following day, Interventional Radiology successfully completed a transjugular intrahepatic portosystemic shunt (TIPS) procedure with a 10 mm x 7 cm Viatorr stent along with deployment of embolization coils into the culprit varix (Figure 1(b)).