Journal of Clinical Interventional Radiology ISVIR (Aug 2022)

Review of Applied Anatomy, Hemodynamics, and Endovascular Management of Ectopic Varices

  • Sitaram Barath,
  • Dharav Kheradia,
  • Shakti Parvathy Gopalkrishnan,
  • Rahul K. R.,
  • Mohammed Rafeeque P. K.

DOI
https://doi.org/10.1055/s-0041-1730868
Journal volume & issue
Vol. 06, no. 02
pp. 106 – 118

Abstract

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Portal hypertension leads to the opening up of collateral pathways to bypass the occlusion or resistance in the portal system. Ectopic varices are formed by such collaterals at many various sites along the gastrointestinal tract other than the usual location, that is, gastroesophageal region. Early diagnosis of ectopic varices needs strong clinical suspicion and contrast-enhanced computed tomography scan as endoscopy may often fail to pinpoint a source. In contrast to gastric varices where the understanding of the disease, as well as endovascular management, is widely studied and documented, the same is not true for ectopic varices due to low incidence. Understanding the applied anatomy and hemodynamic classification is important to decide the most suitable therapy. Interventional radiological procedures are aimed at either decompressing the varices or obliterating them and depend on the patency of the portal system, underlying etiology, and local expertise.

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