A 45-year-old woman begins complaining of chest pain in the post-anesthesia care unit after undergoing an upper endoscopy for evaluation of
esophageal varices. She states the pain radiates to the back. She also complains of
dyspnea, nausea, and she has produced
blood-tinged vomitus. Past medical history is notable for chronic
alcohol use disorder and
liver cirrhosis. Her temperature is 37.5°C (99.5°F),
blood pressure is 107/61 mmHg, and
pulse is 82/min. Physical examination shows a woman in acute distress. Crackles are heard while
auscultating over the heart. Abdominal exam is notable for hepatosplenomegaly. CT imaging reveals the following:
Reproduced from: Radiopedia
Which of the following is the most likely cause of this patient’s presentation?
