PMC4898081_01
60-year-old man with hepatic encephalopathy. Axial CT demonstrates multiple gastric varices (arrow).
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CT of the abdomen revealed an enlarged left renal vein and a complex of gastric varices, suggesting gastro-renal shunting (Fig. 1).
60-year-old man with hepatic encephalopathy. Digital subtraction angiogram shows a 5 French balloon catheter inflated within the outflow tract.
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A retrograde venogram was obtained while the outflow tract was occluded with the balloon (Fig. 2).
60-year-old man with hepatic encephalopathy. A subsequent digital subtraction angiogram demonstrates coils inserted proximal to the gastro-renal shunt outflow tract, providing complete occlusion.
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Azure hydrogel detachable coils (Terumo, Somerset, N.J.). After approximately 15 minutes, complete occlusion of the shunt was observed (Fig. 3).