Abstract
A 21-year-old woman presented with acute severe cholangitis that was treated with intravenous antibiotics and nasobiliary drainage followed by biliary stenting. Subsequent investigation revealed features of extrahepatic portal vein obstruction with a thrombosed splenoportal axis and portal biliopathy as evidenced by dilated intrahepatic biliary ducts, multiple strictures of the extrahepatic bile duct with no filling defects, and venous collaterals around the gallbladder and the common bile duct.
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