The contribution of the intrahepatic portal branch to the gastroesopha
geal varices is rare. This anomalous pathway (a large left intrahepati
c portal branch) was proved by portographic study and by imaging techn
iques in a 54-year-old man with cirrhosis. The overall prevalence of t
his type of collateral in the literature is only 1.9% in 908 patients
with portal hypertension. In addition, all are via the left portal ven
ous branch. It may be speculated that the mechanism of this variation
is due to dilatation of the rest of the intrahepatic portal system via
a small anastomosis due to portal hypertension.