Duodenal and jejunal varices usually occur due to portal hypertension and are rare causes of gastrointestinal tract bleeding. We report the case of a patient with no clinically significant history of a coagulopathy disorder, cirrhosis, or portal hypertension who presented with duodenal and jejunal varices that resulted in lower gastrointestinal bleeding with superior mesenteric vein thrombosis. Mesenteric angiography revealed superior mesenteric vein thrombosis and varices at the fourth part of the duodenum and the proximal jejunum draining into the main portal vein, but no active bleeding source was recognized. The patient was hemodynamically unstable. Emergency laparotomy was performed and revealed duodenal and jejunal varices, with occlusion of the superior mesenteric vein. Partial resection of the duodenum and jejunum and end-to-end anastomosis were performed. After surgery, the patient was hemodynamically stable with no recurrence of bleeding.
 Perea Garcia J, Lago Oliver J, Munoz Jimenez F, del Valle E, Duque Perez C, Turegano Fuentes F. Low gastrointestinal bleeding due to ectopic varices as a result of adhesions] Gastroenterol Hepatol. 2000;23(6):287–289
 Mitchell AW, Jackson JE. Trans-anastomotic portoportal varices in patients with gastrointestinal haemorrhage. Clin Radiol. 2000;55:207–211 http://dx.doi.org/10.1053/crad.1999.0347
 Tang NC, Ibrahim S, Tay KH. Successful management of a bleeding duodenal varix by endoscopic banding. Singapore Med J. 2005;46(12):723–725
 AGA. American gastroenterological association medical position statement: evaluation and management of occult and obscure gastrointestinal bleeding. Gastroenterology 2000;118:197–201 http://dx.doi.org/10.1016/S0016-5085(00)70429-X
 Lin S, Rockey DC. Obscure Gastrointestinal Bleeding. Gastroenterol Clin N Am 2005; 34:679–698 http://dx.doi.org/10.1016/j.gtc.2005.08.005
 Rollins ES, Picus D, Hicks ME, et al. Angiography is useful in detecting the source of chronic gastrointestinal bleeding of obscure origin. AJR Am J Roentgenol 1991;156:385–388
 Moore JD, Thompson NW, Appleman HD, et al. Arteriovenous malformations of the gastrointestinal tract. Arch Surg 1976;111:381–389
 Joo YE, Kim HS, Choi SK, Rew JS, Kim HR, Kim SJ. Massive gastrointestinal bleeding from jejunal varices. J Gastroenterol. 2000;35(10):775–778 http://dx.doi.org/10.1007/s005350070037
 Khouqeer F, Morrow C, Jordan P. Duodenal varices as a cause of massive upper gastrointestinal bleeding. Surgery. 1987;102(3):548–552
 Tang SJ, Jutabha R, Jensen DM. Push enteroscopy for recurrent gastrointestinal hemorrhage due to jejunal anastomotic varices: a case report and review of the literature. Endoscopy. 2002;34(9):735–737 http://dx.doi.org/10.1055/s-2002-33448
 Jonnalagadda SS, Quiason S, Smith OJ. Successful therapy of bleeding duodenal varices by TIPS after failure of sclerotherapy. Am J Gastroenterol. 1998 Feb;93(2):272–274 http://dx.doi.org/10.1111/j.1572-0241.1998.270_3.x
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