Gastrointestinal varices risk factors

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

The most potent risk factor for the development of gastrointestinal varices is increased portal venous pressure. Conditions that predispose an individual to development of increased portal venous pressure and consequently leading to varices can be divided into three. Those leading to development of varices, those involved in progression of varices from small to large size and those leading to variceal hemorrhage.

Risk Factors

The following are the common risk factors that lead to gastrointestinal varices:^[1]

Development of varices

High hepatic venous portal gradient (HPVG > 10 mm Hg)

Progression from small to large varices

Decompensated varices
Alcoholic cirrhosis
Red sign of endoscopy (dilated vessels on the surface of varices)

Variceal hemorrhage

Large varices ( > 5 mm)
Red sign
High MELD score
HVPG > 16 mmHg
Coagulopathy

Thrombocytopenia
Increasing bilirubin
Increased international normalized ratio (INR)
Red marks on the varices
Severe cirrhosis or liver failure
Continued alcohol use

References

↑ Sanyal AJ, Fontana RJ, Di Bisceglie AM, Everhart JE, Doherty MC, Everson GT, Donovan JA, Malet PF, Mehta S, Sheikh MY, Reid AE, Ghany MG, Gretch DR, Halt-C Trial G (2006). “The prevalence and risk factors associated with esophageal varices in subjects with hepatitis C and advanced fibrosis”. Gastrointest. Endosc. 64 (6): 855–64. doi:10.1016/j.gie.2006.03.007. PMID 17140886. Vancouver style error: initials (help)

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[pmid17140886-1] Sanyal AJ, Fontana RJ, Di Bisceglie AM, Everhart JE, Doherty MC, Everson GT, Donovan JA, Malet PF, Mehta S, Sheikh MY, Reid AE, Ghany MG, Gretch DR, Halt-C Trial G (2006). “The prevalence and risk factors associated with esophageal varices in subjects with hepatitis C and advanced fibrosis”. Gastrointest. Endosc. 64 (6): 855–64. doi:10.1016/j.gie.2006.03.007. PMID 17140886. Vancouver style error: initials (help)

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