Esophageal varices are dilated submucosal distal esophageal veins connecting the portal and systemic circulations. This happens due to ...NCBISkiptomaincontentSkiptonavigationResourcesHowToAboutNCBIAccesskeysMyNCBISignintoNCBISignOutNCBIBookshelf.AserviceoftheNationalLibraryofMedicine,NationalInstitutesofHealth.StatPearls[Internet].TreasureIsland(FL):StatPearlsPublishing;2020Jan-.StatPearls[Internet].ShowdetailsTreasureIsland(FL):StatPearlsPublishing;2020Jan-.SearchtermEsophagealVaricesMarcelleMeseeha;MaximosAttia.AuthorInformationAuthorsMarcelleMeseeha;MaximosAttia1.Affiliations1Guthrie/RPHFamilyResidencyProgramLastUpdate:August10,2020.IntroductionEsophagealvaricesaredilatedsubmucosaldistalesophagealveinsconnectingtheportalandsystemiccirculations.Thishappensdueto portalhypertension(mostcommonlyaresultofcirrhosis),resistancetoportalbloodflow,andincreasedportalvenousbloodinflow.The mostcommonfatalcomplicationofcirrhosis isvaricealrupture;theseverityofliverdiseasecorrelateswiththepresenceofvaricesandriskofbleeding.[1][2][3][4]Theportalveinhasacirculationofover1500ml/minofbloodandifthereisanobstruction,thisresultsinelevatedportalvenouspressure.Theresponseofthebodytotheincreasedvenouspressureisthedevelopmentofcollaterals.theseportosystemiccollateralsdivertbloodfromtheportalvenoussystemtotheinferiorandsuperiorvenacava.Atthesametime,oneimportantsystemisthegastroesophagealcollateralsthatdrainintotheazygosveinandleadtothedevelopmentofesophagealvarices.Whenthesevaricesgetenlarged,theyruptureproducingseverehemorrhage.BleedingfromesophagealvaricesisthethirdmostcommoncauseofupperGIbleeding,afterduodenalandgastriculcers.EtiologyCausesofportalhypertension:Prehepatic:Portalveinobstruction(EHPVO)ormassivesplenomegalywithincreasedsplenicveinbloodflowPosthepatic:Severeright-sidedheartfailure,constrictivepericarditis,andhepaticveinobstruction(Budd-Chiarisyndrome)Intrahepatic:Cirrhosisaccountsformostcasesofportalhypertension.Lessfrequentcausesareschistosomiasis,massivefattychange,disea