Bleeding from varicose veins of the esophagus in case of portal hypertension syndrome

Portal hypertension develops due to various reasons, primarily in liver cirrhosis. If the pressure in the portal vein exceeds the pressure in the inferior vena cava for a significant period of time, venous collaterals develop. The most dangerous collaterals are located in the distal esophagus and fundus of the stomach and appear as swollen, convoluted vessels of the submucosa, known as varicose veins. These varicose veins provide a partial decrease in portal pressure, but they can rupture with the development of massive gastrointestinal bleeding. The factor that provokes varicose veins rupture remains unknown, however, it was found that the development of bleeding is practically not observed until the portal / systemic pressure gradient reaches> 12 mm Hg. Art. Coagulopathy within liver disease exacerbates the risk of bleeding.