Portal Hypertension and Bleeding Esophageal Varices

Abstract

THERE are a few well documented cases of bleeding from ruptured esophageal varices in the absence of associated portal hypertension.1 2 3 However, most patients with life-threatening hemorrhage from varices have portal hypertension, proved or assumed, as an underlying cause. Following the example of Whipple,4 most authors emphasize the role of venous obstruction in the production of portal hypertension and its consequences, classifying their cases into "intrahepatic" and "extrahepatic" groups depending on the presumed site of obstruction. Although such a classification simplifies the clinical evaluation and management of variceal bleeding, it ignores other important, nonobstructive etiologic factors. Since the pressure within the . . .