Gastrointestinal varices causes

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

Overview

Causes of gastointestinal varices include all the causes of increased portal venous pressure, which may be divided into cirrhotic and non-cirrhotic causes.

Causes

• Gastrointestinal varices (especially esophageal and gastric) are due to increased pressure in the portal venous system
• The major causes of portal hypertension may be broadly categorized into cirrhotic and non-cirrhotic

Cirrhotic causes

• Chronic hepatitis (B or C)

Non-cirrhotic causes

Pre-hepatic causes

• Portal vein thrombosis
• Splenic vein thrombosis
• Splanchnic arteriovenous fistula
• Splenomegaly (eg, from lymphoma, Gaucher's disease)

Intrahepatic causes

• Presinusoidal:
  • Schistosomiasis
  • Idiopathic non-cirrhotic portal hypertension (including nodular regenerative hyperplasia)
  • Primary biliary cirrhosis
  • Sarcoidosis
  • Congenital hepatic fibrosis
  • Primary sclerosing cholangitis
  • Hepatic arteriopetal fistula
  • Adult polycystic liver disease
  • Arteriovenous fistulas
  • Autoimmune cholangiopathy
  • Vinyl chloride toxicity
  • Neoplastic occlusion of the intra-hepatic portal vein
  • Mineral oil granuloma
• Sinusoidal:
  • Arsenic poisoning
  • Vinyl chloride toxicity
  • Drugs (eg, amiodarone, methotrexate)
  • Alcoholic liver disease
  • Nonalcoholic fatty liver disease
  • Gaucher's disease
  • Zellweger syndrome
  • Viral hepatitis
  • Chronic Q fever
  • Schistosomiasis
  • Amyloid or light-chain deposition in the space of Disse
  • Acute hepatic injury
  • Mastocytosis
  • Agnogenic myeloid metaplasia
  • Acute fatty liver of pregnancy
• Postsinusoidal:
  • Sinusoidal obstruction syndrome (venoocclusive disease)
  • Budd-Chiari syndrome
  • Alcoholic liver disease
  • Chronic radiation injury
  • Vitamin A toxicity
  • Epithelioid hemangioendothelioma
  • Angiosarcoma
  • Sarcoidosis
  • Mycobacterium avium or M. intracellulare infection
  • Mineral oil granuloma

Post-hepatic:

• Inferior vena cava (IVC) obstruction (eg, Budd-Chiari syndrome)
• Cardiac disease (constrictive pericarditis, restrictive cardiomyopathy)