Two cases of esophageal varix caused by local hyperdynamic state of gastric arteries

With increasing evidence on the role of endogenous nitric oxide in the spla nchnic hyperdynamics, the existence of esophageal varix induced by hepatope tal flow of portal hypertension in a cirrhotic patient has become more conv incing. Herein, we report 2 cases of esophageal varix caused by local hyper dynamic states of the right, left and posterior gastric arteries, respectiv ely. Angiographic evidence suggests the existence of forward flows via the submucosal A-V shunt of the gastric arteries as the etiologic causes of the varices. The treatment of the current cases was unsatisfactory due to impr oper recognition of the local hyperdynamic state before the treatment. Unli ke the "backward flow"-type esophageal varix, the treatment strategies of t he "forward flow"-type esophageal varix of hyperdynamic state caused by spl anchnic A-V shunts should be considered differently.