Ali Hassam, Sarfraz Shiza, Sarfraz Abeera
Internal Medicine, East Carolina University, Vidant Medical Center, Greenville, USA.
Anesthesiology, Bahawal Victoria Hospital, Quaid-E-Azam Medical College, Bahawalpur, PAK.
Cureus. 2021 Mar 11;13(3):e13840. doi: 10.7759/cureus.13840.
Downhill or upper esophageal varices have an etiology that differs from that of the "uphill" varices secondary to portal hypertension. Approximately 0.1% of all cases of variceal hemorrhage are due to downhill varices. The underlying etiology is obstruction of the superior vena cava (SVC) which results in the shunting of blood from the systemic circulation into the esophageal plexus, predominantly the upper two-thirds. The management should be directed to relieve the vascular obstruction. One of the causes of SVC obstruction leading to downhill variceal bleeding is dialysis catheter-associated SVC stenosis. We report the case of a 34-year-old male with hematemesis associated with downhill varices due to chronic SVC obstruction because of a central venous catheter.
下行性或上行性食管静脉曲张的病因与门静脉高压继发的“上行性”静脉曲张不同。所有静脉曲张出血病例中约0.1%是由下行性静脉曲张引起的。其潜在病因是上腔静脉（SVC）梗阻，导致血液从体循环分流至食管丛，主要是食管上三分之二部位。治疗应旨在解除血管梗阻。导致下行性静脉曲张出血的上腔静脉梗阻原因之一是透析导管相关的上腔静脉狭窄。我们报告一例34岁男性病例，因中心静脉导管导致慢性上腔静脉梗阻，出现与下行性静脉曲张相关的呕血。
