Successful endoscopic injection sclerotherapy for bleeding from bile duct varices

A 66-year-old man who had undergone hepatic resection and choledochojejunostomy for intrahepatic stones was admitted with dark bloody stools. An endoscopic examination failed to detect the origin of bleeding in the esophagus, stomach, duodenum, or colon. Angiography showed an obstruction of the main trunk of the portal vein and marked cavernous formation of the collateral veins in the hepatoduodenal ligament. The patient was finally found to have variceal bleeding arising from the common bile duct; this was revealed by an endoscopic examination done through a jejunocutaneous fistula created later on. Thereafter, endoscopic injection sclerotherapy was successfully used to treat the hemobilia.