Downhill esophageal varices: A prevalent complication of superior vena cava obstruction from benign and malignant causes

Yoel Siegel, Erica Schallert, Russ Kuker

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Objective: Downhill esophageal varices (DEV) usually develop secondary to superior vena cava (SVC) obstruction. Downhill esophageal varices have been less well characterized compared to uphill varices. The aim of the study was to characterize the anatomy and etiology of DEV by contrastenhanced computed tomography. Methods: Patients with SVC obstruction were included in the study. Downhill esophageal varices were defined as discrete esophageal submucosal or mucosal vessels. Ten random computed tomographic scans were assessed as controls. Results: Downhill esophageal varices were seen in 11 of 36 patients. Three types of varices were observed. Between 1 and 6 varices were seen in each patient with a diameter of 1 to 5 mm. Conclusions: Downhill esophageal varices can be seen in 30% of patients with SVC obstruction. They have several patterns and are mostly systemic-to-systemic collaterals. The most common etiology associated with DEV is renal failure. Downhill esophageal varices are of small caliber, this may in part account for less frequent bleeding compared to uphill varices.

Original languageEnglish (US)
Pages (from-to)149-152
Number of pages4
JournalJournal of Computer Assisted Tomography
Volume39
Issue number2
DOIs
StatePublished - Mar 28 2015

Keywords

  • downhill esophageal varices
  • end-stage renal disease
  • lung cancer
  • superior vena cava obstruction

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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