Pathogenesis of Bleeding in Portal Hypertension

Hemorrhage from ruptured gastroesophageal varices is the main complication of portal hypertension, and represents a major cause of death and of liver transplantation in patients with cirrhosis [1]. Variceal bleeding is the last step of a chain which is initiated by the increase in portal pressure, followed by the formation and progressive dilatation of the varices until these finally rupture and bleed. Approximately 10% of patients having varices will develop variceal hemorrhage per year [2].