PMC5302135_01
Preoperative CT portography showing markedly attenuated portal vein (thin arrow) with huge lieno-renal collateral (thick arrow).
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CT portography showed marked attenuated portal vein and its two main branches, dilated patent tortuous splenic vein, normal patent superior mesenteric vein, multiple dilated splenic hilar collaterals, and large lieno-renal collateral (Fig. 1).
PMC5302135_02
Operative photos showing; A- Huge lieno-renal collateral (arrow), B- After dissection of hepatoduodenal ligament and exposure of healthy portal vein (arrow), C- After completion of graft implantation (arrow at portal vein anastomosis).
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Upon dissection of the hepato-duodenal ligament, a well-developed portal vein could be identified with a small mural thrombus, unlike the preoperative CT findings (Fig. 2).
PMC5302135_03
Follow up CT portography after 6 month showing adequate portal vein anastomosis and its intraparenchymal branching pattern.
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CT showed normal liver graft, and moderate splenomegaly. CT angiography showed normal all vascular anastomoses (Fig. 3).