Transjugular intrahepatic portosystemic shunt in cirrhosis: An exhaustive critical update

Figure 6 Contrast-enhanced computed tomography image. A: Coronal image showing bland occlusive thrombus involving the main portal vein, superior mesenteric vein (SMV) and splenic vein (encircled) with gross ascites (asterisk); B: Image taken 2 wk after transjugular intrahepatic portosystemic shunt (TIPS) shows the stent in situ (arrowhead) with its distal end in one of the major tributaries of SMV. The main trunk of SMV (solid arrow) and splenic vein could not be fully recanalized during TIPS. Trans-splenic access was not taken due to gross ascites; C and D: Corresponding axial images show marked enlargement of the gastroepiploic collaterals (solid orange arrows) arising from the patent portion of splenic vein at splenic hilum draining through the TIPS stent (black arrow in D) into the portal venous system. Note the significant regression of ascites on the follow up scans.