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‘Downhill’ Varices as a Surrogate Marker for Mediastinal or Lung Pathology: A Case Report
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‘Downhill’ varices are dilated veins resulting from SVC obstruction whose blood flow is directed caudally towards azygous vein or inferior vena cava. Their etiology differs from that of the usual “uphill” varices secondary to portal hypertension. We report a case of 63 year old male that was suspected to have mediastinal / lung pathology based on finding of downhill varix on diagnostic esophagogastroduodenoscopy despite normal chest X- ray. Subsequently, the lung pathology was confirmed on contrast enhanced tomography of chest and on bronchoscopy. So findings of ‘downhill’varices on endoscopy can suggest lung/medistinal pathology which needs to be confirmed on subsequent testing.
Keywords
Esophagogastroduodenoscopy, Red color sign, Contrast Enhanced Computed Tomography, Endoscopic Band Ligation.
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