A rare solitary varix in the descending part of the duodenum secondary to superior mesenteric vein stenosis: A case report

This case report presents a rare instance of varices in the descending part of the duodenum caused by superior mesenteric vein stenosis following abdominal trauma. A 50-year-old male patient presented with chronic recurrent gastrointestinal bleeding due to duodenal varices. Notably, the patient had no history of liver cirrhosis and had previously undergone multiple unsuccessful surgical procedures, including splenectomy, splenorenal shunt, and a mesocaval shunt using the right gastroepiploic vein. During the current admission, gastroscopy identified bleeding duodenal varices. The patient was treated with endoscopic sclerotherapy and tissue adhesive injection and was followed for 46 months. Although the initial therapeutic outcome was favorable, rebleeding occurred in the 47th month and was successfully managed with repeat endoscopic treatment. This case demonstrates that endoscopic therapy is a safe and effective management strategy for variceal bleeding resulting from this rare etiology; however, long-term follow-up is essential due to the potential for recurrence.