Extremely dilated sub-mucosal veins in the lower third of the esophagus, due to portal hypertension caused by liver
cirrhosis. They can cause severe upper gastrointestinal bleeding.
- Screen patients with liver cirrhosis with endoscopy to assess for presence of varices
- In case of varices, consider the use of beta blockers to prevent bleeding
- Propranolol 20 mg every 12 hours, titrate to keep resting heart rate at 55-60 bpm
- Avoid in refractery ascitis and SBP
- Endoscopic ligation sclerotherapy
- If acute bleeding.