Diagnosis: Esophageal Varices (Fluoroscopy)


  • Esophageal varices are dilated submucosal veins of the esophagus due to the development of collateral drainage vessels
  • Esophageal varices are typically seen in setting of portal hypertension
  • In patients with esophageal varices, they can present with signs of upper GI bleed; hematemesis or melena
  • On fluoroscopy on barium swallow, there will be filling defects that are serpiginous and longitudinal
  • Esophageal varices are abnormal, enlarged veins that develop in the esophagus, usually caused by portal hypertension, a condition in which the blood pressure in the portal vein is too high.
  • On a fluoroscopic examination, esophageal varices typically appear as swollen, tortuous (twisted) veins that are located in the lower part of the esophagus. They may appear as a single large vein or as multiple smaller veins. In severe cases, the varices may be so large that they compress the surrounding tissue, causing the esophagus to appear narrowed or “string-like.”
  • It is important to note that the appearance of esophageal varices on a fluoroscopic examination can vary depending on the size and location of the varices, as well as the patient’s position during the examination. In some cases, varices may not be visible on a fluoroscopic examination, especially if they are small or located in areas that are difficult to visualize. In these cases, other imaging tests, such as an upper endoscopy, may be needed to confirm the diagnosis.

Credit: Case submitted by Saeed Rad MD to radRounds Radiology Network