We present the case of a 70-year-old female who underwent liver transplantation in 2011 due to enolic cirrhosis with a normofunction graft and no portal hypertension. During the last months, recurrent hospitalization was needed due to hepatic encephalopathy, in spite of treatment with lactulose and rifaximin. An abdominal computed tomography (CT) showed a large varicose dilatation of the splenic vein up to 14-16 mm, descending by the left abdominal side, communicating with the renal vein with direct drainage into inferior cava vein (ICV).