Endoscopic Management of Acute Bleeding from an Ectopic Duodenal Varix

Urgent upper gastrointestinal endoscopy was performed and documented a small esophageal varix without evidence of recent bleeding and, in the inferior wall of the second portion of the duodenum, a 20-mm elevated longitudinal lesion with a central hematinic depression, at that time misinterpreted as a subepithelial lesion with a visible vessel, and therefore, an endoclip was placed ( Fig. 1 ). Further investigation with endoscopic ultrasound (EUS) showed that the previously identified duodenal subepithelial lesion was in fact a 13-mm-large duodenal ectopic varix ( Fig. 2 a). Endoscopic injection of 4.8 mL of cyanoacrylate and lipiodol (0.5: 0.7) was successfully per