Pathophysiology of variceal bleeding in cirrhotics

Cirrhosis of the liver is a highly prevalent disease worldwide, accompanied by profound disturbances in the splanchnic hemodynamics. These are not limited to the intrahepatic circulation, but involve also the splanchnic and systemic circulatory beds. These hemodynamic disorders cause the development of portal hypertension, which appears in the majority of patients with cirrhosis and is responsible for its most frequent clinical features: ascites, renal dysfunction, hepatic encephalopathy and massive gastrointestinal bleeding from ruptured gastroesophageal varices and other portal hypertension-related lesions.