Case submitted by Saeed Rad, M.D., radiologist, to

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 Patient presents with a history of excessive alcohol (ETOH) intake with increasing difficulty swallowing (dysphagia).

Esophageal varices are seen in over half of patients with portal hypertension, such as in the case of long standing alcohol intake. This is such a case. It is important to note there are other causes of cirrhosis and portal hypertension beyond alcohol intake, including Chid-Pugh C cirrhosis or other causes of liver disease that result in cirrhosis. 

Esophageal varices are dilated submucosal veins of the esophagus and are portosystemic collaterals. Fluoroscopic evaluation with barium demonstrates longitudinal and curvilinear luminal filling defects, representing varices.

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What is your diagnosis in this patient with long standing excessive alcohol intake and difficulty swallowing?

Image IQ Quiz: Patient Presents with Increasing Difficulty Swallowing