Question

Identify the image given in UGIE (Upper Gastrointestinal Endoscopy):

• A. Barrett’s esophagus
• B. Esophageal varices
• C. Gastric erosion
• D.

Hint:

Esophageal varices are a common finding in patients with liver cirrhosis and portal hypertension, and they require careful management to prevent life-threatening bleeding.

Answer 1

The Correct Option is B

Step 1: Set the clinical frame.
This is an upper GI endoscopy. The pattern recognition question asks which lesion the picture shows in the lower oesophagus / gastro-oesophageal region.

Step 2: Pin down the discriminating sign.
The classic finding for the correct entity is dilated, tortuous, bluish, serpentine (snake-like) submucosal veins bulging into the lower oesophageal lumen, running as longitudinal columns toward the gastro-oesophageal junction. These engorged collateral veins are the endoscopic signature of oesophageal varices, which form because portal hypertension forces blood through porto-systemic collaterals at the lower oesophagus.

Step 3: Contrast with the distractors so the match is unambiguous.
• Barrett's oesophagus would appear as salmon-pink columnar mucosa extending in tongues up from the GE junction - a colour/mucosal change, not raised vessels.
• Gastric erosion is a shallow mucosal break or superficial defect on the stomach lining - a flat lesion, not dilated veins.
Neither shows the bluish dilated venous columns in the picture.

Step 4: Conclusion.
The dilated bluish serpentine veins identify the lesion as varices arising from portal hypertension.

Final answer: Option 2 - Esophageal varices.