2026 Volume 68 Issue 9 Pages 1544-1551
A 52-year-old woman underwent pancreaticoduodenectomy 29 months earlier for a hypervascular tumor in the pancreatic head that was diagnosed as a neuroendocrine tumor（G1）. During surgery, portal vein injury occurred, necessitating portal vein resection and reconstruction. Postoperatively, portal vein thrombosis led to a hemorrhagic ulcer at the choledochojejunostomy site, making it impossible to continue anticoagulation. Portal vein stenosis worsened gradually. The patient presented to the emergency department with hematemesis. Contrast-enhanced computed tomography revealed biliary variceal bleeding due to cavernous transformation of the portal vein. To reduce portal hypertension and control the bleeding, partial splenic artery embolization was performed. After the procedure, the patient experienced no bleeding recurrence, and the clinical course was uneventful.
