Portal vein cavernous transformation at bilioenteric anastomosis

摘要

A 30-year-old woman presented with a 3-year history of recurrent melena, without haematemesis, abdominal pain or fever. The lowest hemoglobin was 30 g/L. She had a history of congenital choledochal cyst and underwent extrahepatic bile duct resection with Roux-en-Y cholangiojejunostomy 26 years ago. Eight years before, she got abdominal cavity infection following by pancreatic pseudocyst. Gastroscopy and colonoscopy showed no bleeding lesions. Computed tomography scan revealed portal vein cavernous transformation ( , red arrow) at bilioenteric anastomosis ( , yellow arrow). Roux-en-Y loop varices ( , white arrow) bleeding due to portal hypertension caused by portal vein cavernous transformation ( , red arrow) was suspected. She received treatment for this obscure gastrointestinal bleeding but eventually died of massive hemorrhage.