DESPITE the prevalence of portal hypertension with esophageal and gastric varices, the occurrence of varices in other portions of the gastrointestinal tract is a rarity. Duodenal varices were first reported in 1931 by Alberti,1 who described the radiologic findings in three cases. Subsequently, only 15 cases have been reported in the English literature. This paper describes the findings in, and treatment of, a patient with bleeding duodenal varices caused by portal and splenic vein thromboses with cavernous transformation of the portal vein. Report of a Case A 58-year-old white man was admitted to the Greenpoint Hospital on Nov 21, 1964, because of hematemesis and melena of five hours' duration. Several years earlier, he had been told that he had an enlarged spleen and "cirrhosis," but had never been jaundiced. He could recall no symptoms referable to the gastrointestinal tract except for an episode of abdominal pain 30 years earlier,