ANATOMI

DEFENISI• Varises esofagus adalah terjadinya distensi vena submukosa

yang diproyeksikan ke dalam lumen esofagus • Varises gastroesofagus berhubungan dengan tingkat

keparahan penyakit hati

• Deranged (vascular) architecture

CIRRHOSIS

• vasoconstrictor/ dilator imbalance

Hyperdinamic circulation • adrenergic system

(increased cardiac index)

• renin - angiotensin system (renal Na⁻ and water retention)

Counterregulatory mechanism

• increased portal blood flow

• increased resistance to portal flow

Portal hypertension

World Gastroenterology Organisation Global Guidelines, 2014

Epidemiology of esophageal varices and correlation with liver disease

HVPG = hepatic venous pressure gradient; IGV = isolated gastric varices in absence of esophageal varices located in gastric fundus; GOV2 = gastroesophageal varices extending along greater curvature toward gastric fundus

Klasifikasi beratnya sirosis Child-Pugh

INR, international normalized ratio; PT, prothrombin time

World Gastroenterology Organisation Global Guidelines, 2014