Successful Treatment of a Case of Ectopic Jejunal Varices with Portal Venous Stenting

Patient: Female, 77 Final Diagnosis: Ectopic variceal bleeding of the jejunum Symptoms: Abdominal pain • hematemesis • melena Medication: — Clinical Procedure: Portal vein stenting Specialty: Gastroenterology and Hepatology OBJECTIVE: Unusual clinical course BACKGROUND: Management of patients with ectopic variceal bleeding can be challenging and requires a multidisciplinary approach. Ectopic bleeding from jejunal varices at the anastomotic site of choledochojejunostomy is rare and difficult to treat. CASE REPORT: We report a case of ectopic jejunal variceal bleeding secondary to portal vein stenosis at the anastomotic site of a prior choledochojejunostomy for pancreatic cancer. The patient was successfully treated with portal vein metallic stent placement that remained patent for 7 months. CONCLUSIONS: The management of ectopic of variceal bleeding remains difficult and controversial. Portal vein stenting has been reported as a successful method of treatment that is minimally invasive especially in patients who had prior major surgeries.