Downhill Esophageal Varices: a Therapeutic Dilemma

Authors

Raja C. Chakinala, New York Medical College
Anila Kumar, New York Medical CollegeFollow
Jonathan E. Barsa, New York Medical College
Dhruv Mehta, New York Medical CollegeFollow
Khwaja F. Haq, New York Medical College
Shantanu Solanki, New York Medical College
Virendra Tewari, New York Medical College
Wilbert S. Aronow, New York Medical CollegeFollow

DOI

10.21037/atm.2018.11.13

Journal Title

Annals of Translational Medicine

First Page

463

Document Type

Article

Publication Date

December 2018

Department

Medicine

Keywords

Downhill Esophageal Varices, Gastrointestinal Bleeding, Superior Vena Cava Obstruction (SVC Obstruction)

Disciplines

Medicine and Health Sciences

Abstract

Esophageal varices can cause life-threatening complications and are most often a sequela of liver disease. Although a rare cause of gastrointestinal bleeding, downhill variceal bleeding secondary to superior vena cava (SVC) obstruction should be considered in the differential diagnosis for patients with upper gastrointestinal hemorrhage. We discuss two such cases of downhill esophageal varices presenting with hematemesis in patients with end stage renal disease and no history of cirrhosis. These varices were thought to be secondary to SVC occlusion caused by complications from previous dialysis catheters. However, their difficult anatomy posed a significant challenge to the therapeutic interventions.

Recommended Citation

Chakinala, R. C., Kumar, A., Barsa, J., Mehta, D., Haq, K., Solanki, S., Tewari, V., & Aronow, W. (2018). Downhill Esophageal Varices: a Therapeutic Dilemma. Annals of Translational Medicine, 6 (23), 463. https://doi.org/10.21037/atm.2018.11.13