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Fig. 4B. —43-year-old man with onset of abdominal pain, worsening hyperglycemia, and decreasing levels of urinary amylase beginning 3 weeks after resection of previously failed pancreatic graft and placement of new pancreatic graft. Conventional venogram of inferior vena cava and common iliac veins confirms occlusion of portal venous anastomosis of pancreas transplant located in right lower quadrant. Note reflux of contrast material into patent vein of transplanted kidney in left lower quadrant (arrow). Patient was successfully treated with intraarterial infusion of tissue plasminogen activator, angioplasty, and systemic anticoagulation.