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Transjugular intrahepatic portosystemic shunt (TIPS) creation can be very beneficial to decrease high portal pressure and its consequent dreadful complications, such as variceal hemorrhage. However, some anatomical limitations such as portal vein thrombosis can make TIPS technically impossible to perform. Here, we describe a case of a 72-year-old female patient who previously had a Roux-En-Y choledochojejunostomy, which was complicated by portal vein thrombosis. The patient subsequently developed portal hypertension, and this was successfully treated with endovascular mesocaval shunt creation, given that TIPS was not a viable option. 

Treatment of Noncirrhotic Portal Hypertension Secondary to Portal Vein Thrombosis With Endovascular Mesocaval Shunt Creation