From the Guidelines
Gastric varices are abnormally enlarged veins in the stomach that develop when blood flow through the liver is blocked, causing blood to back up and find alternative routes through smaller vessels. These swollen veins typically occur in patients with portal hypertension, most commonly due to liver cirrhosis [ 1 ]. Unlike esophageal varices which form in the esophagus, gastric varices specifically develop in the stomach lining and can be classified into different types based on their location. They pose a serious health risk because they can rupture and cause severe, potentially life-threatening bleeding. Some key points to consider about gastric varices include:
- They are a complication of portal hypertension, often due to liver cirrhosis [ 1 ]
- Treatment options include medications like beta-blockers to reduce portal pressure [ 1 ]
- Endoscopic procedures such as injection of tissue adhesives like cyanoacrylate glue are effective in controlling bleeding [ 1 ]
- TIPS (transjugular intrahepatic portosystemic shunt) procedure to redirect blood flow, or balloon-occluded retrograde transvenous obliteration (BRTO) may also be used [ 1 ]
- Patients with gastric varices require regular monitoring through endoscopy and management of the underlying liver disease [ 1 ]
- The condition is serious because bleeding from gastric varices is often more severe and harder to control than bleeding from esophageal varices, with higher mortality rates if not promptly treated [ 1 ]
From the Research
Definition of Gastric Varicose
- Gastric varicose, also known as gastric varices, are dilated submucosal veins that often develop at sites near the formation of gastroesophageal collateral circulation 2.
- They are a type of porto-systemic collateral that can occur in the esophagus, stomach, or ectopic varices 2.
Causes and Risk Factors
- Gastric varices are a complication of portal hypertension, which is often caused by liver cirrhosis 3, 4, 2.
- The incidence of varices is on the rise due to alcohol and obesity 2.
- Patients with cirrhosis are at risk of developing gastric varices, with approximately 40% to 95% of people with cirrhosis having oesophageal varices 5.
Complications
- The most significant complication of portal hypertension is life-threatening bleeding from gastrointestinal varices, which is associated with substantial morbidity and mortality 2.
- Recurrent variceal bleed is common, and in some cases, there is refractory variceal bleed 2.
- Gastric varices can cause a significant burden on healthcare facilities 2.