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"A Surprise Calcification"



Case of the Week 272

What's the most likely diagnosis?

  • 51 year-old with dysphagia

  1. Renal cell carcinoma
  2. Sickle cell disease
  3. Hiatal hernia
  4. Esophageal varices
  5. Lymphoma



4. Esophageal varices



More (Click Discussion Tab)

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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