Esophageal varices are dilated veins forming vesicles on the lower portion of the esophagus and stomach. These are highly sensitive to pressure like coughing and sneezing which leads to its easy rupture and bleeding. This causes other health problems like anemia from unrecognized and untreated mild bleeding. 95% of all cases of esophageal varices are caused by portal hypertension and liver problems. The remaining 5% of cases are from splenic vein and abnormalities of superior vena cava circulation. Mortality rate with bleeding esophageal varices is very high due to shock and liver failure; however, with early detection and proper management, this decreases.
The hallmark of bleeding esophageal varices are hematemesis or the vomiting of bright red blood and melena or the passing of black tarry stools. These are somewhat and commonly mistaken as signs of upper gastrointestinal bleeding (UGIB) from ulcer. It is true that bleeding esophageal varices is a form of UGIB, but, it is more serious and requires immediate attention, something that some physicians don’t recognize. Also, its managements are different and more complex than any other form of UGIB.
Complications of untreated or misdiagnosed bleeding esophageal varices include chronic anemia from recurrent hemorrhages and systemic encephalopathy from liver failure.