Which finding is most characteristic of portal hypertension and a common source of bleeding?

Which finding is most characteristic of portal hypertension and a common source of bleeding?

• A. Esophageal varices
• B. Caput medusae
• C. Anorectal varices
• D. Pallor without signs of bleeding

Answer: (A)

In portal hypertension, blood is pushed through alternative pathways (collaterals) to bypass the high pressure in the portal system. The esophageal veins at the gastroesophageal junction become dilated, forming esophageal varices. These varices are thin-walled and lie just beneath the mucosa, so they are highly prone to rupture under the elevated pressures, making them a common and characteristic source of life-threatening bleeding in this condition. Caput medusae indicate portal hypertension too, but they are abdominal wall varices and less typically a major bleeding source. Anorectal varices can bleed but are not as emblematic or as high-yield a source as esophageal varices. Pallor without signs of bleeding doesn’t point to a specific bleeding source in portal hypertension.

In portal hypertension, blood is pushed through alternative pathways (collaterals) to bypass the high pressure in the portal system. The esophageal veins at the gastroesophageal junction become dilated, forming esophageal varices. These varices are thin-walled and lie just beneath the mucosa, so they are highly prone to rupture under the elevated pressures, making them a common and characteristic source of life-threatening bleeding in this condition.

Caput medusae indicate portal hypertension too, but they are abdominal wall varices and less typically a major bleeding source. Anorectal varices can bleed but are not as emblematic or as high-yield a source as esophageal varices. Pallor without signs of bleeding doesn’t point to a specific bleeding source in portal hypertension.