Introduction to gastro-oesophageal varices

Gastro-oesophageal varices are enlarged submucosal, portosystemic veins that may develop in patients with portal hypertension. Varices are present in 35 to 50% of patients with cirrhosis and are more prevalent in decompensated cirrhosis.

Gastro-oesophageal varices are asymptomatic until they rupture and cause gastrointestinal bleeding. In patients with cirrhosis, the risk of bleeding is high (7 to 8% per year), and the mortality from an acute bleed ranges from 10 to 20%.

Endoscopic assessment of varices for size and signs of imminent rupture (red spots, fibrin plug) is used to stratify varices into high risk (varices needing treatment) or low risk (varices not needing treatment) of haemorrhage. For information about endoscopic variceal surveillance, see below.