Table 1.

Diagnosis of gastroesophageal variceal bleeding (adapted from Sarin et al Hepatol Int 2011)⁶³

Upper gastrointestinal endoscopy (EGD) is the gold standard for the diagnosis of acute variceal bleeding. A diagnosis of gastroesophageal variceal bleeding is made if any of the following criteria is satisfied.
1. Direct visualization of blood (spurting or oozing) arising from an esophageal or gastric varix.
2. Presence of gastroesophageal varix with signs of recent bleed (stigmata) such as white nipple sign or overlying clot.
3. Presence of varix with red signs plus presence of blood in the stomach in the absence of another source of bleeding.
4. Presence of varix with red signs (cherry red spots- small ~2 mm, red, spotty flat spot on the variceal surface, red wale signs- longitudinal read streaks on the variceal surface, hematocystic spots- large, >3 mm, round, discrete, red raised spots on the variceal surface) and clinical signs of upper gastrointestinal bleeding, without blood in the stomach.