Which statement best identifies a major complication associated with esophageal varices?

Which statement best identifies a major complication associated with esophageal varices?

• A. Development of ascites due to portal hypertension.
• B. Rupture and bleeding due to distention of submucosal veins.
• C. Formation of collateral venous channels without bleeding.
• D. Variceal perforation leading to pneumomediastinum.

Answer: (B)

Esophageal varices are dilated submucosal veins that form because of portal hypertension. The walls of these varices are thin and under high pressure, so the most dangerous and defining complication is rupture with brisk bleeding. When a varix bleeds, it can cause rapid blood loss, hypovolemia, and shock, making it a life-threatening emergency and the primary cause of mortality related to esophageal varices. While portal hypertension can lead to ascites, that outcome is not specific to varices and isn’t the major complication of the varices themselves. Formation of collateral channels is how varices develop, not an ongoing complication, and perforation with pneumomediastinum is rare and not the typical scenario clinicians focus on with variceal disease.

Esophageal varices are dilated submucosal veins that form because of portal hypertension. The walls of these varices are thin and under high pressure, so the most dangerous and defining complication is rupture with brisk bleeding. When a varix bleeds, it can cause rapid blood loss, hypovolemia, and shock, making it a life-threatening emergency and the primary cause of mortality related to esophageal varices.

While portal hypertension can lead to ascites, that outcome is not specific to varices and isn’t the major complication of the varices themselves. Formation of collateral channels is how varices develop, not an ongoing complication, and perforation with pneumomediastinum is rare and not the typical scenario clinicians focus on with variceal disease.