Abstract
A 49-year-old man was admitted to our hospital with melena. Endoscopically, massive bleeding was noted from the top of a bluish elevated lesion in the second portion of the duodenum, which was regarded as duodenal varix (Figure 1). The bleeding could be stopped by injection of pure ethanol into the lesion (Figure 2). Fourteen days after the injection, laparotomy was performed because of the rebleeding. The lesion was resected and it was proved to be an isolated duodenal varix histologically (Figure 3, 4). Angiogram, abdominal CT, abdominal US and other examinations were performed after laparotomy, but there was no evidence of portal hypertension (Figure 5, 6) and any other varices. Therefore, this varix probably represents a congenital vascular malformation. Ninety seven cases have been reported about duodenal varices since the first report of Alberti in 1931 (Table 2), but most of them were due to portal hypertension (Table 3). Only 3 cases which was thought due to vascular malformation has been reported.
