An overview of downhill esophageal varices: a challenge for medical practice
Objectives Unlike the commonly seen uphill esophageal varices in clinical practice, downhill esophageal varices are caused by obstruction of the superior vena cava and azygous venous system. The predominant causes of downhill esophageal varices are hemodialysis in end-stage renal disease patients an...
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| Format: | Article |
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2462452 |
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| author | Donghong Wang Zhibin Ma |
| author_facet | Donghong Wang Zhibin Ma |
| author_sort | Donghong Wang |
| collection | DOAJ |
| description | Objectives Unlike the commonly seen uphill esophageal varices in clinical practice, downhill esophageal varices are caused by obstruction of the superior vena cava and azygous venous system. The predominant causes of downhill esophageal varices are hemodialysis in end-stage renal disease patients and mediastinal malignancies. The cornerstone of the treatment for downhill esophageal varices is to address the underlying primary causes. Without this, patients may suffer from recurrent bleeding, and the bleeding can be fatal.Methods This review is primarily summarized through previous case reports. Meanwhile, it emphasizes the significance of case reports.Results Clinicians should be conscious that esophageal varices are not necessarily caused by liver cirrhosis or non-cirrhotic portal hypertension.Conclusions Specifically, when varices are only observed in the upper and middle esophagus, and the patient presents with evidence of superior vena cava obstruction, clinicians should be particularly vigilant for downhill esophageal varices. Moreover, a thorough investigation and definitive treatment of the underlying primary causes should be implemented. |
| format | Article |
| id | doaj-art-d80e11c067dc4a299ba916e1b9cfd7fe |
| institution | Kabale University |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-d80e11c067dc4a299ba916e1b9cfd7fe2025-02-04T16:34:29ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2462452An overview of downhill esophageal varices: a challenge for medical practiceDonghong Wang0Zhibin Ma1Department of Internal Medicine, Harbin Medical University, Harbin, Heilongjiang, ChinaDepartment of Internal Medicine, Harbin Medical University, Harbin, Heilongjiang, ChinaObjectives Unlike the commonly seen uphill esophageal varices in clinical practice, downhill esophageal varices are caused by obstruction of the superior vena cava and azygous venous system. The predominant causes of downhill esophageal varices are hemodialysis in end-stage renal disease patients and mediastinal malignancies. The cornerstone of the treatment for downhill esophageal varices is to address the underlying primary causes. Without this, patients may suffer from recurrent bleeding, and the bleeding can be fatal.Methods This review is primarily summarized through previous case reports. Meanwhile, it emphasizes the significance of case reports.Results Clinicians should be conscious that esophageal varices are not necessarily caused by liver cirrhosis or non-cirrhotic portal hypertension.Conclusions Specifically, when varices are only observed in the upper and middle esophagus, and the patient presents with evidence of superior vena cava obstruction, clinicians should be particularly vigilant for downhill esophageal varices. Moreover, a thorough investigation and definitive treatment of the underlying primary causes should be implemented.https://www.tandfonline.com/doi/10.1080/07853890.2025.2462452Downhill esophageal variceshemodialysismediastinal malignancy |
| spellingShingle | Donghong Wang Zhibin Ma An overview of downhill esophageal varices: a challenge for medical practice Annals of Medicine Downhill esophageal varices hemodialysis mediastinal malignancy |
| title | An overview of downhill esophageal varices: a challenge for medical practice |
| title_full | An overview of downhill esophageal varices: a challenge for medical practice |
| title_fullStr | An overview of downhill esophageal varices: a challenge for medical practice |
| title_full_unstemmed | An overview of downhill esophageal varices: a challenge for medical practice |
| title_short | An overview of downhill esophageal varices: a challenge for medical practice |
| title_sort | overview of downhill esophageal varices a challenge for medical practice |
| topic | Downhill esophageal varices hemodialysis mediastinal malignancy |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2462452 |
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