Esophageal varices

Esophageal stricture caused by endoscopic sclerotherapy. Single-contrast esophagogram shows a long, irregular stricture in the distal esophagus (straight white arrows) that resulted from scarring caused by prior endoscopic sclerotherapy for esophageal varices. Note also the flat ulcer in the region of the stricture (curved white arrow). Black arrows indicate a transjugular intrahepatic portosystemic shunt.

Prone RAO spot image from single-contrast esophagography shows uphill esophageal varices as serpiginous defects in lower esophagus. This patient had portal hypertension.

Varices in ARPKD. (a) Esophagogram demonstrates several serpiginous filling defects (arrows) in the lower esophagus, consistent with esophageal varices. (b) Axial contrast-enhanced CT scan obtained through the upper abdomen shows enlarged and tortuous splenic veins (arrows), indicating portal hypertension.

Upright LPO spot image from double-contrast esophagography shows downhill esophageal varices as serpiginous defects in midesophagus above the level of the carina. This patient had superior vena cava syndrome.

Barium esophagogram. (a) Anteroposterior orthostatic projection shows several filling defects in the middle and distal segments of the esophagus. (b) Left posterior oblique projection shows sharply marginated, longitudinal, and serpentine lesions that mimic varices and that did not change in size or configuration with respiratory maneuvers or repositioning of the patient. Esophageal peristalsis was normal.

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