Unravelling the downhill spiral: A Tale of Alcohol, Varices, and a Hidden Stenosis

Authors

Edris Adel, Department of Internal Medicine, MedStar Union Memorial Hospital, BaltimoreFollow
Urwah Ahmad, Department of Internal Medicine, MedStar Union Memorial Hospital, Baltimore,
Ramya Vasireddy, Department of Medicine, 201 E University Pkwy, Baltimore, MD 21218, United States
Jasmine Barrow, Center for Digestive Disease, MedStar Franklin Square Medical Center, Baltimore

Abstract

Downhill esophageal varices (EVs) were first described in 1964 by Felson and Lessure.¹ They are rare with an incidence rate of 0.5% in the general population.¹ They usually develop due to an increase in pressure and/or obstruction of the superior vena cava (SVC) and rarely present with hematemesis. SVC syndrome, surgical ligation of the SVC, Castleman syndrome, pulmonary hypertension, and hypercontractile esophageal motility disorders can cause this.¹ We report a case of downhill EVs in an older male with alcohol use disorder with incidental finding

of SVC stenosis secondary to an old, unused chemotherapy port.

Recommended Citation

Adel, Edris; Ahmad, Urwah; Vasireddy, Ramya; and Barrow, Jasmine (2025) "Unravelling the downhill spiral: A Tale of Alcohol, Varices, and a Hidden Stenosis," Journal of Community Hospital Internal Medicine Perspectives: Vol. 15: Iss. 6, Article 6.
DOI: 10.55729/2000-9666.1553
Available at: https://scholarlycommons.gbmc.org/jchimp/vol15/iss6/6

DOI

10.55729/2000-9666.1553