Bleeding oesophageal varices in the absence of intrahepatic or extrahepatic obstruction of the portal system and without portal hypertension.

OESOPHAGEAL VARICES are generally secondary to portal hypertension and are therefore usually associated with obstruction to the portal circulation within the liver as in cirrhosis or in the portal vein itself. Thus, according to the site of obstruction, portal hypertension is usually classified as intrahepatic or extrahepatic in type (Whipple, 1945). However, an increasing number of cases of portal hypertension with extensive collateral circulation in the absence of any demonstrable organic obstruction, are being reported (Osler 1900; Rousselot 1940; Pemberton and Kiernon 1945; Whipple 1945; Hallenbeck and Shocket 1957; Tisdale et al 1959; Leather 1961; Imanaga et al 1952; Polish et al 1962; Siderys and Vellios 1964; Turnberg 1964). Varices have also been noted in patients with liver disease but without demonstrable elevation of portal pressure (Morton et al 1954; Homer et al 1964). There have been few reports, however, of varices in the absence of either liver disease or portal hypertension. The following case is an example of this unusual and interesting condition.