Ectopic Varices: A Primer

Abstract Esophageal varices (EV) are observed in patients with cirrhotic and noncirrhotic portal hypertension. Ectopic varices (ECV) occur outside the esophagogastric region, are less common, and often more challenging to diagnose and effectively manage. The absence of an EV source on endoscopy should raise concern for ECV in patients with significant non-arterial bleeding within the abdomen or gastrointestinal tract. Patient clinical factors including cirrhosis, portal vein thrombosis, and prior abdominal or pelvic surgery warrant an approach for identifying a treatable ECV source. This article offers a descriptive approach to diagnosing and managing ECV in patients with portal hypertension.