Patient male, 36 years old, hospitalization number 4568219, was admitted to our hospital on 08/19/2015 for 2 years after emergency pancreaticoduodenectomy, recurrent bloody stools for one year, aggravated for half a month. 2 years ago, he underwent emergency pancreaticoduodenectomy in an outside hospital due to a car accident resulting in pancreatic rupture, duodenal rupture, retroperitoneal hematoma, multiple fractures of bilateral ribs, diffuse peritonitis, hemorrhagic shock, and 5 months after surgery, he developed He had recurrent black stools 5 months after surgery, and the local diagnosis was: residual gastric varices, superior mesenteric vein thrombosis, portal hypertension, and in the last half month, black stools were frequent and increased in volume, so he requested surgery and was transferred to our hospital. After examination, the diagnosis was: left-sided portal hypertension, ruptured bleeding esophagogastric fundic varices, complex abdominal adhesions, incisional hernia, and post-pancreaticoduodenectomy. Complex intestinal adhesion release, splenectomy, and selective perigastric vascular dissection were performed on 08/24/2015. Intraoperatively, he saw extensive dense abdominal adhesions, omental defects, no portal vein pressure measurement, normal liver, enlarged spleen, chronic inflammatory changes in the pancreas with hard texture, obvious perigastric varices, dilated multiple gastric vein penetrations, about 0.5 cm in size, short gastric veins about 1.5 cm in diameter, minimal esophageal vein penetrations, and no obvious paraesophageal veins (see below). The initial postoperative recovery was good, and on the 17th postoperative day there was a sudden onset of epigastric pain without obvious cause, accompanied by panic and dizziness, and black stool appeared about 10 hours later, 0 – 1 time per day, which gradually improved after two weeks of symptomatic treatment, and the stool turned yellow, which was considered to be due to ectopic varices in combination with the preoperative portal venous system in three dimensions. He was discharged on 09/29/2015.