Bleeding from gastric varices is a life-threatening complication of portal hypertension. Fundal and isolated gastric varices are at high risk for variceal bleeding. The first episode of variceal bleeding is not only associated with a high mortality, but also with a high recurrence rate in those who survive. Gastrointestinal (GI) hemorrhage from portal hypertension is the most ominous form of bleeding. It carries the highest mortality, ranging from 30 to 40% and has an equally high rate of recurrence. Vascular collaterals in the stomach, esophagus, small bowel , and colon form as a consequence of portal hypertension, and these vessels have a high risk of rupture. The vascular congestion can also lead to mucosal bleeding throughout the GI tract from portal hypertensive gastropathy, enteropathy, and colopathy.
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