Gastric varices. Problem in diagnosis

Gastric varices may appear in association with esophageal varices secondary to portal-hypertension or as an independent manifestation of splenic vein obstruction. Since gastric varices often manifest as radiologic filling defects in the gastric fundus or cardia, differentiation from tumors and many other diseases becomes imperative. Unfortunately, routine diagnostic pprocedures may be of limited value. The difficulties in the diagnosis of gastric varices are illustrated with three specific cases. Correct diagnosis is best established with the aid of endoscopy and such special procedures as celiac angiography or splenoportography. With the help of three cases, the characteristics of gastric varices are reviewed and their evaluation and management are outlined.