Esophageal varices - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Esophageal varices are a direct consequence of portal hypertension as a progressive complication of cirrhosis.
The development of bleeding carries significant morbidity and mortality.
Nonselective beta-blockers and/or endoscopic ligation can prevent the development of variceal bleeding.
Acute hemorrhage can be managed with resuscitation, a vasoactive drug or a somatostatin analog, and endoscopic ligation. Additional management may include transjugular intrahepatic shunt therapy and prophylactic antibiotics.
Diagnosis and surveillance by endoscopy is an important aspect of management.

Large esophageal varices

From the personal collection of Gennaro d'Amico, MD

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History & Exam
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Large esophageal varices
Large esophageal varices
(A) Grade I esophageal varices. These collapse to inflation of the esophagus with air. (B) Grade II esophageal varices. These are varices between grades 1 and 3. (C) Grade III esophageal varices. These are large enough to occlude the lumen

Citations

Key Articles

Garcia-Tsao G, Abraldes JG, Berzigotti A, et al. Portal hypertensive bleeding in cirrhosis: risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the Study of Liver Diseases. Hepatology. 2017 Jan;65(1):310-35.[Abstract][Full Text]
de Franchis R, Bosch J, Garcia-Tsao G, et al. Baveno VII - renewing consensus in portal hypertension. J Hepatol. 2022 Apr;76(4):959-74.[Abstract][Full Text]

Referenced Articles

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