An unusual cause of portal hypertension in a cirrhotic patient

Gastrointestinal bleeding is a frequent and severe complication of cirrhosis. The rupture of esophageal
varices is the leading cause of upper gastrointestinal bleeding in cirrhosis. It occurs in about 30 to 40% of patients
with liver cirrhosis and esophageal varices. A multidisciplinary approach is needed as it is a life-threatening condition.
Trans-jugular intra-hepatic portosystemic shunt (TIPS) is the elected procedure in the management of refractory bleeding
to drug and endoscopic treatment.
We report the case of the casual discovery of splenic arteriovenous fistula while performing TIPS in the context of
alcoholic liver cirrhosis associating oesophageal varices and portal hypertension.