Atypical Endoscopic Appearance of a Rare Cause of Gastrointestinal Bleeding: Superior Mesenteric Vein Occlusion Causing Colon Varices.

Colonic varices (CV) are an uncommon cause of gastrointestinal bleeding, with an incidence of only 0.07%. We present a case of a 34-year-old woman with chronic superior mesenteric vein occlusion after pancreatoduodenectomy, leading to diffuse colonic varices with an atypical appearance needing further evaluation. Subsequent angiography confirmed CV, which were treated with catheter-based superior mesenteric vein stenting and variceal coiling. The patient's bleeding was controlled, with plans for continued surveillance. This case emphasizes the diagnostic challenges, treatment complexities, and the need for individualized management strategies for CV, highlighting the urgent need for established guidelines.