PMC6085233_01
Upper gastrointestinal endoscopy: A) A flat and elevated lesion with an unclear border (size: 15 mm, 0-IIa + IIc) localized at the anterior wall in the lower third of the stomach. B) Endoscopic view after acetic acid was sprinkled.
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Endoscopic findings revealed a tumor located at the anterior wall in the lower third of the stomach (Fig. 1).
A) Axial CT angiography images of the abdomen revealed portal vein stricture (arrow) and increased presence of collateral veins around the liver hilum. B) Coronal CT angiography image of the abdomen revealed similar findings.
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CT angiography showed similar findings with CT that indicate portal blood flow was maintained by the RGV-LGV shunt (Fig. 2, Fig. 3).
Operative findings. Revascularization of the LGV and the RGV after gastrectomy and lymphadenectomy (arrow).
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We performed LVG-RVG shunt, vascular anastomosis, lymph node dissection, and distal gastrectomy (Fig. 4).