DOI: https://doi.org/10.36347/sasjm.2026.v12i05.012

Pages: 432-436

Ectopic varices represent a rare cause of gastrointestinal bleeding, accounting for less than 5% of bleeding episodes related to portal hypertension [1]. Jejunal localization is exceptional and represents both a diagnostic and therapeutic challenge. We report the case of a 25-year-old patient with no known history of liver disease who was admitted for melena evolving for six days associated with deterioration of general condition. Initial laboratory evaluation revealed severe anemia (hemoglobin: 3 g/dL) requiring transfusion of nine units of packed red blood cells. Abdominal CT angiography demonstrated a portal cavernoma extending to the superior mesenteric vein with suspicion of an ectopic varix in the proximal jejunum. Upper gastrointestinal endoscopy followed by enteroscopy revealed a large jejunal varix measuring approximately 4 cm with a central ulceration corresponding to the bleeding site. Hemostasis was achieved by endoscopic injection of 2 ml of cyanoacrylate (Histoacryl). Clinical evolution was favorable after hemodynamic stabilization and partial correction of anemia (hemoglobin: 8.32 g/dL). Jejunal ectopic varices are an exceptional but serious cause of gastrointestinal bleeding. Diagnosis relies on imaging and endoscopic evaluation. Injection of biological glue represents an effective emergency therapeutic option.