Published online Oct 28, 2013. doi: 10.4329/wjr.v5.i10.381
Revised: September 2, 2013
Accepted: October 16, 2013
Published online: October 28, 2013
Core tip: The significance of bleeding from a portal venous origin following blunt hepatic trauma in the setting of portal hypertension, the potential role of indirect carbon dioxide venogram in identifying massive portal hemorrhage, and the use of a multiphase computed tomography of the liver in a trauma case with suspected internal bleeding and known portal hypertension are discussed. These cases illustrate attempted endovascular treatment of portal vein injury utilizing a transjugular intrahepatic portosystemic shunt in one scenario and transmesocaval shunt coiling of a jejunal varix in the other. Further research is needed to elucidate outcomes of portal interventions in the setting of coexisting portal hypertension and hemorrhage.