{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T08:16:49Z","timestamp":1765354609245,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,2,15]]},"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:p>A 74-year-old man presented to our hospital with recurrent lower gastrointestinal bleeding. His past medical history was remarkable for a duodenal papilla carcinoma and he underwent a pylorus-preserving pancreaticoduodenectomy 4\u2009years before. During diagnostic work-up a severe portal vein stenosis after surgery and multiple dilated intramural jejunal varices, which formed as collateral pathways could be detected. Based on these findings, the recurrent haemorrhages were considered to be due to repeated rupturing and bleeding of jejunal varices. Therapeutically, the portal vein stenosis was treated with endovascular stent placement leading to a reduction in prestenotic portal pressure. During follow-up no further episodes of gastrointestinal bleeding were observed. Bleeding from jejunal varices is a very rare cause of gastrointestinal haemorrhages and represents a diagnostic and therapeutic challenge. However, it should be considered in differential diagnosis of obscure recurrent gastrointestinal haemorrhages in patients with a history of hepato-pancreato-biliary surgery.<\/jats:p>","DOI":"10.1136\/bcr-2018-228527","type":"journal-article","created":{"date-parts":[[2019,3,14]],"date-time":"2019-03-14T10:57:42Z","timestamp":1552561062000},"page":"e228527","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Jejunal varices as a rare cause of recurrent gastrointestinal bleeding in a 74-year-old man with extrahepatic portal hypertension after pancreato-biliary surgery"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6218-2239","authenticated-orcid":false,"given":"Philipp","family":"Kasper","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospital of Cologne, Cologne, North Rhine-Westphalia, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Schramm","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospital of Cologne, Cologne, North Rhine-Westphalia, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"Jaspers","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospital of Cologne, Cologne, North Rhine-Westphalia, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Goeser","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospital of Cologne, Cologne, North Rhine-Westphalia, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,3,14]]},"reference":[{"key":"2025082709425075000_12.3.e228527.1","doi-asserted-by":"crossref","first-page":"321","DOI":"10.3346\/jkms.2012.27.3.321","article-title":"Jejunal variceal bleeding successfully treated with percutaneous coil embolization","volume":"27","author":"Koo","year":"2012","journal-title":"J Korean Med Sci"},{"key":"2025082709425075000_12.3.e228527.2","doi-asserted-by":"crossref","first-page":"828","DOI":"10.3348\/kjr.2017.18.5.828","article-title":"Portal Vein Stenting for Delayed Jejunal Varix Bleeding Associated with Portal Venous Occlusion after Hepatobiliary and Pancreatic Surgery","volume":"18","author":"Hyun","year":"2017","journal-title":"Korean J Radiol"},{"key":"2025082709425075000_12.3.e228527.3","first-page":"514","article-title":"Jejunal varices as a cause of massive gastrointestinal bleeding","volume":"87","author":"Yuki","year":"1992","journal-title":"Am J Gastroenterol"},{"key":"2025082709425075000_12.3.e228527.4","doi-asserted-by":"publisher","DOI":"10.1007\/s005350070037"},{"key":"2025082709425075000_12.3.e228527.5","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1038\/ajg.2016.191","article-title":"Massive Gastrointestinal Bleeding Due to Isolated Jejunal Varices in a Patient With Extrahepatic Portal Hypertension: A Case Report","volume":"111","author":"Mansoor","year":"2016","journal-title":"Am J Gastroenterol"},{"key":"2025082709425075000_12.3.e228527.6","doi-asserted-by":"publisher","DOI":"10.1007\/s00534-004-0941-4"},{"key":"2025082709425075000_12.3.e228527.7","doi-asserted-by":"publisher","DOI":"10.1007\/s005950170013"},{"key":"2025082709425075000_12.3.e228527.8","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1055\/s-0032-1309834","article-title":"Successful treatment of anastomotic jejunal varices with N-butyl-2-cyanoacrylate (Histoacryl): single-center experience","volume":"44","author":"Gubler","year":"2012","journal-title":"Endoscopy"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-228527","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:42:59Z","timestamp":1756312979000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-228527"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3]]},"references-count":8,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,3,14]]},"published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1136\/bcr-2018-228527"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-228527","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,3]]}}}