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Findings: Images from an angiogram during a portal venous phase demonstrate multiple rounded serpiginous contrast filled vessels within the left upper quadrant. The portal vein is patent.

Diagnosis: Gastroesophageal varices.

Discussion: Gastric varices are a common finding in patients with portal hypertension. Many collateral pathways can be identified with patients with portal hypertension including the left coronary vein, renal vessels, para-umbilical vessels, lumbar collaterals as well as superior hemorrhoidal vessels.

Classification of portal hypertension can be broken down into the prehepatic, intrahepatic as well as post hepatic.

References:
Freeny P. Radiology, Lippincott, Philadelphia, 1988; 63:1-12.

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