[Fatal bleeding from duodenal varix]
In portal hypertension, varices can also develop in other parts of the GI tract including the anorectal region, colon, and small intestine. Portal hypertensive gastropathy, colopathy, and enteropathy are other sequelae.
Primay duodenal varices are rare and are usually found incidentally at the time of endoscopy, more often in patients with extrahepatic portal vein obstruction or in cirrhotics with portal vein thrombosis. Usually the afferent vessel of the duodenal varices is the superior or inferior pancreaticoduodenal vein originating in the portal vein trunk or superior mesenteric vein. The efferent vain drains into the inferior vena cava. In a review of 169 cases of bleeding ectopic varices, 17% occurred in the duodenum, 17% in the jejunum or ileum, 14% in the colon, 8% in the rectum, and 9% in the peritoneum. [Ginsberg textbook 2005]
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