A 21-year-old man was hospitalized with repeated bleeding from the gastrointestinal tract, the cause of which could not be detected by gastroscopy, colonoscopy or arteriography. After the third surgical intervention he died of uncontrollable bleeding. At autopsy, marked and partly ulcerated duodenal varices were found to be the cause of the bleeding. They were part of a collateral circulation that had developed from chronic obstruction of the inferior vena cava, where thrombosis had arisen in association with neonatal renal vein thrombosis. There was consecutive renal infarction which had required a left nephrectomy on the 2nd day after birth.
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