An unusual cause of portal hypertension in a cirrhotic patient

Gastrointerstinal bleeding is a frequent and severe complication of cirrhosis. The rupture of esophageal varices is the main cause of upper gastrointestinal bleeding in cirrhosis. It occurs in about 30 to 40% of patients with liver cirrhosis and esophageal varices. Multidisciplinary approach is need 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