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A 64-year-old man was admitted to our hospital with hematemesis and melena.Six years ago,he had undergone total gastrectomy with Roux-en-Y esophagojejunostomy for gastric cancer.Endoscopic examination revealed varicose veins at the anastomotic sites with cherry-red spots and hemorrhage.Abdominal computed tomography showed that the varices were supplied by a dilated jejunal vein.Transjugular intrahepatic portosystemic shunt (TIPS) and variceal embolization were performed.There were no major complications or episodes of bleeding during the three-month follow-up.We conclude that TIPS in combination with varices obliteration is an effective alteative method for treatment of ruptured esophagojejunal varices after total gastrectomy.