DIGESTIVE HEMORRHAGE CAUSED BY DUODENAL V ARICES

Duodenal varices are uncommon and are frequently diagnosed late. Howev er, they are a potential cause of massive bleeding, with tendency to r elapse. We would like to offer as an example a case diagnosed by means of an endoscopy. A patient without oesophageal varices and with obstr uction of the splenic-portal axis and venous calcifications is reporte d. A disminution in the volume of the duodenal varices with inspirator y movements may help in the differential diagnosis during endoscopy. W e emphasize the need of avoiding incorrect maneuvres during endoscopy and the value of ultrasonography and CAT scan to confirm the diagnosis . Sclerotherapy appears to be the best therapeutic approach. Percutane ous embolization and surgery are therapeutic alternatives if sclerosis is not effective. However in some cases with self-limited bleeding an d a low tendency to relapse, as with the patient described herein, a c onservative attitude should be selected.