Esophageal varices are dilated veins in the wall of the lower esophagus that develop when high pressure in the portal venous system, usually from liver cirrhosis, forces blood to find alternative pathways back to the heart. While esophageal varices are primarily diagnosed and treated through endoscopy, ultrasound plays an important role by identifying the underlying portal hypertension that causes them. Doppler ultrasound findings suggesting portal hypertension include an enlarged portal vein, reversed flow in the portal vein, the presence of collateral vessels, splenomegaly, and ascites. Recognizing these signs on abdominal ultrasound can alert clinicians to the likelihood of varices and the risk of potentially fatal variceal bleeding.
Sonography Term