The natural history of bleeding gastric varices differs from that of esophageal varices. Although the risk of bleeding from gastric varices is half that of esophageal varices, the transfusion requirements and mortality once bleeding has occurred are greater particularly for IGV. It has been reported that patients with large gastric varices have a lower portal pressure than those with esophageal varices, which may be as a result of the development of gastrorenal porto-systemic shunts, or large size of the varices resulting in increased variceal wall tension.
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