Abstract
A 47-year-old woman presented with abdominal pain. Abdominal computed tomography and barium follow-through radiography showed segmental small bowel ischemia of the jejunum, and she was treated conservatively. Endoscopic retrograde cholangiography was perf omed, because her urine amylase, gamma-glutamyl transpeptidase, and alkaline phosphatase were elevated on admission. This examination revealed an intraluminal filling defect in the bile duct. Furthermore, a superior mesenteric arteriogram showed complete extrahepatic portal venous obstruction with collateral vessels near the porta hepatis. These examinations demonstrated portal vein thrombosis developed idiopathically, which led small bowel ischemia and collateral vessels associated with bile duct varices. Bile duct varices are common in patients with extrahepatic portal venous obstructions, whereas patients with no symptoms are recommended to be kept under obsevation, since spontaneous variceal hemorrhage or severe obstructive jaundice needing treatment are extremely rare.
