Q:

Which of the following statement(s) is/are true concerning the pathophysiology of variceal hemorrhage?

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Which of the following statement(s) is/are true concerning the pathophysiology of variceal hemorrhage?


  1. All patients with portal hypertension will develop esophageal varices
  2. All patients with esophageal varices eventually bleed
  3. Variceal size can predict the incidence of variceal hemorrhage
  4. Control of acid secretion by H2 blockade can decrease the incidence of rebleeding after esophageal hemorrhage
  5. None of the above

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e. None of the above

About two-thirds of patients with portal hypertension develop varices; of these only two-thirds subsequently experience variceal hemorrhage. A number of factors are important in the pathogenesis of variceal hemorrhage. These include portal pressure, intravariceal pressure, variceal size and structure, and other factors. Variceal size alone is not predictive of variceal hemorrhage. Evidence conflicts about whether erosive esophagitis is a cause of variceal rupture. Control of acid reflux by H2 blockade has not been shown to decrease the incidence of rebleeding after esophageal hemorrhage.

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