oesophagus, varicose veins of

Abnormally swollen veins in the wall of the oesophagus, brought about by increased flow of blood from the stomach and portal vein, a circulatory disorder usually caused by cirrhosis of the liver. Connective tissue formed in the liver in this condition constricts the capillaries in the liver, inhibiting flow in the portal vein. This increase in pressure works back through the system, finally causing varicose veins in the oesophagus. Such varicose veins can cause haemorrhage without warning: food moving along the oesophagus bursts one of the protruding veins, causing violent haemorrhage and the vomiting of blood (haematemesis). Such haemorrhage is potentially fatal. Treatment is by medication to close the blood vessels or the introduction of a balloon to seal them by physical pressure. When the haemorrhage is staunched it is possible to make a connection (shunt) between the portal vein and another major vein, thus taking intestinal blood past the liver, reducing pressure in the portal vein and shrinking the varicose veins.