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Can a patient with oesophageal varices have normal liver?

Q: I am a 60 years old woman having oesophageal varices. Can a patient with oesophageal varices have absolutely normal liver like not showing any damage in sonography, endoscopy, blood tests and liver function test? Please advise.

A:Your question is very difficult to answer and I as a physician have not seen an isolated oesophageal varix in the absence of any detectable abnormality in the liver as the oesophageal varices develop in an already established increased portal venous pressure in the liver and this ought to show some changes either in the scans or liver function. Having said this, liver as an organ has a tremendous capacity to react to pressure changes and I suppose it is theoretically possible that in very early stages this could happen before there is evidence of increased pressure in the liver. There are sophisticated tests available to measure portal blood pressure and this will give a definite answer as to if indeed there is a normal liver or not. I suggest that you consult a liver specialist with facilities to be able to study portal blood pressure for a definitive answer.

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