Esophageal Varices-I: Introduction

Esophageal varices are enlarged and twisted veins primarily located in the submucosa of the lower esophagus and stomach, posing a significant risk of rupture and severe bleeding.

The primary cause of esophageal varices is portal hypertension, a condition arising from impaired portal venous circulation within a damaged liver.

This impairment causes increased obstruction in the hepatic portal vein, which impairs blood transport from the gastrointestinal system to the liver.

As a result, venous blood from the intestinal tract and spleen seeks alternative routes through collateral circulation. This process involves creating new pathways to redirect blood flow back to the heart's right atrium.

Collateral circulation in the lower esophagus and stomach leads to the development of fragile blood vessels, increasing the pressure in these veins.

This elevated pressure causes the veins to expand and form varices prone to bleeding due to the lack of elasticity.

Other causes of esophageal varices include portal vein thrombosis, right-sided heart failure, hepatic vein obstruction, splenomegaly with increased splenic vein blood flow, and heavy alcohol consumption.