Gastric Varices

Excerpt

Gastric varices are dilated submucosal collateral veins that develop in the setting of portal hypertension due to any etiology with or without cirrhosis. Compared to esophageal varices, gastric varices are less common occurring in approximately 20% of cirrhotic patients. However, gastric varices have a higher propensity to bleed severely and are often associated with poor patient outcomes. Based on their stomach location, gastric varices are classified as gastroesophageal varices (GOV) and isolated gastric varices (IGV).

Among all the different classifications available to describe gastric varices, Sarin et al.'s classification are the most commonly used. Gastroesophageal varices are extensions of esophageal varices and are termed as GOV type 1(GOV1) when they extend below the gastroesophageal junction along the lesser curvature and GOV type 2(GOV2) when they extend into the fundus of the stomach. Isolated gastric varices (IGV) located in the fundus of the stomach are termed IGV type 1(IGV1) or commonly referred to as fundal varices. IGV type 2(IGV2) are ectopic varices located anywhere in the stomach. GOV1 represents almost 75% of all gastric varices, followed by GOV2, 21%, IGV1 less than 2%, and IGV2, which comprises 4%.