Portal vein Recanalization via Paraumbilical vein with Direct Intrahepatic Portosystemic Shunt (PVR-DIPS) in Chronic Budd-Chiari Syndrome with Extrahepatic Portal Venous Obstruction.

Direct intrahepatic portosystemic shunt (DIPS) with access to the portal vein from the IVC remains a viable option to ameliorate features of portal hypertension in patients of BCS with chronically thrombosed hepatic veins. We present a case of BCS with concurrent extrahepatic portal vein obstruction (EHPVO), in which portal vein recanalization (PVR) was achieved utilizing recanalized paraumbilical venous access. Subsequently PVR-DIPS was performed to ameliorate features of portal hypertension.