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Varices is a topic covered in the 5-Minute Emergency Consult.

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  • Increased portal venous pressure results in portal–systemic shunts.
  • Shunts at gastroesophageal junction result in fragile submucosal esophageal varices.


  • 10–30% of all cases of upper GI bleeding
  • 90% of upper GI bleeding in patients with cirrhosis
  • Variceal hemorrhage occurs in 30% of patients with cirrhosis:
    • 50% will stop bleeding spontaneously
    • 30% mortality per episode
    • 70% have recurrent bleeding
  • In adults:
    • Cirrhosis due to alcoholism or chronic hepatitis
    • Storage disease: Wilson or hemochromatosis
    • Middle East: Schistosomiasis
  • In children:
    • Intrahepatic obstruction from biliary cirrhosis
    • Biliary atresia
    • Cystic fibrosis
    • β-antitrypsin deficiency
    • Hepatitis

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Rosen, Peter, et al., editors. "Varices." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307322/all/Varices.
Varices. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307322/all/Varices. Accessed April 23, 2019.
Varices. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307322/all/Varices
Varices [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 23]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307322/all/Varices.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Varices ID - 307322 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307322/all/Varices PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -