We report a case with extrahepatic portal venous obstruction (EHPVO), who p
resented with recurrent bleeding following a previous devascularization pro
cedure and needed an emergency distal spleno-renal shunt (DSRS). Due to tec
hnical difficulty because of previous scarring, the adrenal vein was used a
s a conduit between the splenic vein and renal vein. The shunt's patent and
the patient has been bleed-free for 2 years.