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Revista Española de Enfermedades Digestivas

Print version ISSN 1130-0108

Abstract

AREIA, M. et al. "Downhill" varices: A rare cause of esophageal hemorrhage. Rev. esp. enferm. dig. [online]. 2006, vol.98, n.5, pp.359-361. ISSN 1130-0108.

"Downhill" varices or upper esophageal varices are a rare cause of proximal digestive tract hemorrhage with only 16 cases described in the literature. In our series, hemorrhage due to "Downhill" varices represents 0.1% of all acute esophageal variceal bleeding. Their etiology differs from that of the usual "uphill' varices secondary to portal hypertension, and the clinical management should be directed to vascular obstruction if present. We report a case of an 89-year-old male with hemorrhagic "Downhill" varices not associated, as usually, with superior vena cava obstruction or compression, but with severe pulmonary hypertension and drug-related hemorrhagic risk factors, whose removal proved sufficient to prevent rebleeding.

Keywords : Esophageal and gastric varices; Gastrointestinal hemorrhage; Pulmonary hypertension.

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