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Table 1: Clinical course of the patient.

Date Pathological condition Management 10.2003 Idiopathic extrahepatic portal and superior mesenteric vein thrombosis, because of elevated factor VIII level, complicated with portal hypertension Administration of phenprocoumon for anticoagulation (discontinued because of episodes of variceal bleeding), and beta-blocker and nitrate for portal hypertension 12.2003 Bleeding episodes from grade II oesophageal varices Endoscopic sclerotherapy 04.2004 Grade I portal biliopathy Endoscopic complete bile duct stone clearance and insertion of a biliary endoprosthesis, administration of ursodesoxicholic acid 06.2004–02.2007 Numerous relapsing episodes of symptomatic portal biliopathy Multiple ERCP sessions and stent changes without a definitive improvement 04.2007 Symptomatic portal biliopathy- decision making for surgical management Open cholecystectomy and an alternative portosystemic shunt (right porto-ovarian H-shunt) 05.2007–present None. The patient did not developed encephalopathy while she has had no further episodes of bleeding, jaundice, abdominal pain, or recurrent fever No therapeutic intervention was required