Clinical Presentation

The patient is a 64-year-old woman with a massive gastrointestinal (GI) bleed.

(A) Late phase of a selective splenic artery injection shows large gastric varices (black arrow) but no esophageal varices. The course of the splenic vein appears interrupted and is abnormal (white arrow). There is faint opacification of the inferior vena cava (double black arrows). (B)