Downhill esophageal varices associated with superior vena cava syndrome – A case report

Authors

DOI:

https://doi.org/10.33448/rsd-v11i10.33003

Keywords:

Superior Vena Cava Syndrome; Esophageal varices; Gastrointestinal hemorrhage; Case report.

Abstract

Objective: Esophageal varices are an important cause of digestive bleeding, with uphill varices secondary to portal hypertension being the most common cause. Downhill esophageal varices are rare, are related to superior vena cava obstruction, and require investigation as to their etiology, as appropriate treatment is related to the underlying cause and is essential to reduce the risk of complications. Methodology: A review of the patient's chart was carried out, as well as an extensive literature search on downhill esophageal varices, with a detailed study of their etiology, pathophysiology, diagnosis, and treatment. The correlations between the case and the findings in the literature are also presented. Case report: A 52-year-old patient presented with clinical manifestations of superior vena cava syndrome and endoscopic findings of downhill esophageal varices. A complementary investigation with computed tomography of the chest was performed, and chronic thrombosis of the superior vena cava with extensive collateral circulation was diagnosed. The investigation of thrombophilia was negative, and the etiology of the thrombosis was defined as idiopathic. Conclusion: The importance of recognizing, diagnosing downhill esophageal varices, and understanding their pathophysiology for adequate etiological investigation and early treatment, as well as reducing the risks of gastrointestinal bleeding, are highlighted in this case.

Author Biographies

Mariana Almeida Hein, Universidade Federal do Triângulo Mineiro

Physician of the Medical Residency Program in Gastroenterology

Danielle Duarte Silva, Universidade Federal do Triângulo Mineiro

Physician of the Medical Residency Program in Gastroenterology

Otávio Romanini Lopes, Universidade Federal do Triângulo Mineiro

Medicine student

Matheus Soares Braga , Universidade Federal do Triângulo Mineiro

Medicine student

Anderson Lubito Simoni, Universidade Federal do Triângulo Mineiro

Vascular Surgeon, Surgical Clinic Unit

Bruno Doriguetto Couto Ferreira, Universidade Federal do Triângulo Mineiro

Radiologist, Diagnostic Imaging and Specialized Diagnostics Unit

Luís Ronan M. F. de Souza, Universidade Federal do Triângulo Mineiro

Radiologist, professor, Department of Internal Medicine

Geisa Perez Medina Gomide, Universidade Federal do Triângulo Mineiro

Gastroenterologist, professor at the Department of Internal Medicine

Ana Flávia Carrijo Chiovato, Universidade Federal do Triângulo Mineiro

Gastroenterologist, professor at the Department of Internal Medicine

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Published

06/08/2022

How to Cite

HEIN, M. A. .; SILVA, D. D. .; LOPES, O. R. .; BRAGA , M. S. .; SIMONI, A. L. .; FERREIRA, B. D. C. .; SOUZA, L. R. M. F. de .; GOMIDE, G. P. M. .; CHIOVATO, A. F. C. . Downhill esophageal varices associated with superior vena cava syndrome – A case report . Research, Society and Development, [S. l.], v. 11, n. 10, p. e438111033003, 2022. DOI: 10.33448/rsd-v11i10.33003. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/33003. Acesso em: 1 oct. 2022.

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Section

Health Sciences