What's the most likely diagnosis?
- 51 year-old with dysphagia
- Renal cell carcinoma
- Sickle cell disease
- Hiatal hernia
- Esophageal varices
- Lymphoma
Answer:
4. Esophageal varices
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Esophageal Varices
- Dilated submucosal veins due to increased collateral blood flow from portal venous system to azygos system
- Uphill varices
- Collateral blood flow from portal vein via azygos vein into SVC (usually lower esophagus drains via left gastric vein into portal vein)
- Most common cause is portal hypertension secondary to cirrhosis
- Varices in lower half of esophagus to the level of the carina (azygous vein)
- More common than downhill varices
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