Fig. 6. A 27-year-old male with a history of schistosomiasis associated portal hypertension presents with recurrent upper gastrointestinal bleeding secondary to esophageal varices. (A) Digital subtraction angiography (DSA) performed through a pigtail catheter within the main portal vein after a Rosch-Uchida transjugular intrahepatic portosystemic shunt trochar-needle set (Cook Medical) are advanced from the right hepatic vein through the hepatic parenchyma into the right portal vein. Note the dilated coronary vein arising from the main portal vein and Linton balloon in the stomach. (B) Delayed DSA images demonstrate prominent and extensive esophageal varices and gastric varices along the lesser curvature of the stomach (asterisk). (C) Subsequently, polytetrafluoroethylene-covered stent was placed across the parenchymal tract (arrow). (D) Transvenous injection of liquid embolic agent in the coronary vein and esophageal varices.
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