Portal vein recanalization with collateral embolization via transcollateral TIPS in a patient with EHPVO and portal choledochal fistula

Extrahepatic portal vein obstruction (EHPVO) is a liver condition characterized by the development of prehepatic portal hypertension and its associated complications, such as gastrointestinal bleeding, portal cholangiopathy, and ascites. Endovascular portal decompressive procedures—including transjugular intrahepatic portosystemic shunt (TIPS) and portal vein recanalization (PVR)—as well as surgical shunt procedures, are available for the management of portal hypertension-related complications. Here, we report a case of EHPVO with portal biliopathy and a portal choledochal fistula that was initially managed with transcollateral TIPS and PVR, followed by collateral embolization.