Pathogenesis (development of disease)
Esophageal varices are the result of portal hypertension (portal hypertension: increase in pressure in the portal vein > 12 mmHg), as often occurs in the setting of liver cirrhosis (liver shrinkage).The portal vein (vena portae) collects blood from the veins of the unpaired abdominal organs (gastrointestinal tract/gastrointestinal tract and spleen) and delivers it to the liver. There, among other things, the elimination of toxins takes place, most of which are metabolized (metabolized) in the liver. Due to advanced liver disease, blood flow through the liver is severely impaired, resulting in portal congestion (blood backing up into the portal circulation) and consequent portal hypertension. Portocaval anastomoses (bypasses between portal and caval venous systems) develop, one of which leads to the esophagus (food pipe). Collaterals (collateral branches) of veins located in the lower esophageal area, among others, receive increased blood flow to equalize pressure. They dilate (widen) and esophageal varices form.
Etiology (causes)
Behavioral causes
- Pleasure food consumption
- Alcohol (woman: > 40 g/day; man: > 60 g/day).
Disease-related causes
- Alcohol abuse (alcohol dependence)
- Liver cirrhosis (liver shrinkage)
- Right heart failure (right heart failure)
- Thrombosis in the splenic vein (splenic vein), the internal vena cava (inferior vena cava) or the portal vein (portal vein)
- Tumor in the area of the splenic vein, the vena cava interior or the portal vein
- Viral hepatitis
