A patient has spider angiomata and liver dysfunction. Which clinical finding is likely to accompany elevated portal vein pressure?

• A. Esophageal varices
• B. Ascites
• C. Hepatic encephalopathy
• D. Jaundice

Answer: (A)

In the context of elevated portal vein pressure, which is often seen in conditions such as cirrhosis or hepatic venous obstruction, esophageal varices are a significant clinical finding. These varices are dilated veins that develop in the esophagus or stomach due to increased pressure in the portal vein system, which can occur as a result of liver dysfunction and conditions that cause portal hypertension.

As the pressure rises, collateral circulation develops, leading to the formation of these varices. Patients may present with esophageal varices as a complication, which can result in potentially life-threatening hemorrhage if they rupture. The presence of spider angiomata and liver dysfunction suggests underlying liver disease, which supports the likelihood of developing esophageal varices due to increased portal pressure.

While ascites, hepatic encephalopathy, and jaundice are also possible complications of liver dysfunction and elevated portal pressure, esophageal varices are particularly associated with the direct consequences of portal hypertension and serve as a critical risk factor for gastrointestinal bleeding. This makes them a prominent clinical finding in the scenario described.