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Downhill esophageal varix

Last revised by Dr Jayanth Keshavamurthy on 12 Oct 2019

Downhill esophageal varices are an uncommon type of esophageal varices associated with superior vena cava (SVC) obstruction.

Downhill oesophagal varices are less frequently seen. It is seen in less than 0.5% of routine upper endoscopies. Most common etiology is superior vena obstruction of any cause. It is seen in almost 30% of the cases of SVC obstruction 1.

The underlying cause for SVC obstruction and symptoms related to that. It bleeds less often than more common uphill esophageal varices which is seen in portal hypertension. There is no associated cirrhosis or portal hypertension of any cause.

Treating the underlying cause of SVC obstruction.

The first description of the downhill esophageal varices located in the upper third of the esophagus without the existence of portal hypertension was in 1964 by Felson and Lessure 2.

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Cases and figures

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