Bleeding Duodenal Varices after Gastroesophageal Varices Ligation: A Case Report

Duodenal varices are rarely occurring sites of hemorrhage in patients with portal hypertension, and such hemorrhaging can be a life-threatening event. We report the case of a 58-year-old woman with cirrhosis who presented with melena after successful ligation of gastroesophageal varices 1 week earlier. Upper gastrointestinal endoscopy revealed bleeding duodenal varices in the second portion of the duodenum, which was considered to be the source of the bleeding. Endoscopic injection sclerotherapy with histoacryl and lipiodol achieved successful hemostasis. Nonetheless, the sclerosant spread to the lungs via a portosystemic shunt, causing a pulmonary embolism. This is a rare complication seldom reported in the world literature.