Esophageal Varices And Liver Cirrhosis: Understanding The Connection

Esophageal varices are primarily caused by portal hypertension, a condition characterized by increased blood pressure within the portal venous system. This elevated pressure can lead to the development of enlarged veins in the lower part of the esophagus and upper part of the stomach. While liver cirrhosis is a common cause of portal hypertension, it's important to note that not all cases of portal hypertension are due to cirrhosis.

In clinical practice, imaging techniques such as abdominal CT scans are valuable diagnostic tools for identifying portal hypertension. These scans may reveal an enlarged portal vein, along with signs of vascular dilation around the lower esophagus and stomach. Additional findings might include splenomegaly (enlarged spleen) and ascites (fluid accumulation in the abdominal cavity). The most definitive method for diagnosing esophageal varices remains endoscopic evaluation, which allows direct visualization of the esophagogastric junction.

While liver cirrhosis accounts for the majority of portal hypertension cases, other conditions can produce similar effects. Portal vein cavernous transformation represents another significant cause of portal hypertension that doesn't involve liver cirrhosis. Additionally, certain pancreatic disorders - particularly tumors located in the body or tail of the pancreas, or severe pancreatitis - can obstruct splenic vein drainage. This obstruction can result in regional portal hypertension of pancreatic origin, ultimately causing esophagogastric varices without the presence of liver cirrhosis.