A case of asymptomatic primary biliary cirrhosis with an initial presenting feature of localized gastric varices

A case of asymptomatic primary biliary cirrhosis (PBC) with an initial presenting feature of localized gastric varices is reported. The patient, 64 years old female, underwent a barium meal examination because of ill-defined abdominal complaints and was found to have gastric varices localized at the cardia but no esophageal varices. Her blood chemistry showed high values of biliary tract enzymes such as alkaline phosphatase and gamma-glutamyl transpeptidase, but the serum bilirubin level was almost normal. Serum anti-mitochondrial antibody was positive. Histological findings of the surgically biopsied liver specimen were compatible with PBC. The clinical implication of gastric varices in PBC is discussed.