Foaming at the Varix: Sclerotherapy of Esophageal Varices via Intrahepatic Portal Vein Access.

A 65-year-old woman with cirrhosis complicated by recent variceal bleeding requiring endoscopic band ligation was admitted to the hospital with lightheadedness and dark stools. The patient underwent an esophagogastroduodenoscopy, which showed worsening of her varices with large areas of confluence and 1 column protruding more than 50% into the lumen of the esophagus (Figure A). Multiple red wale signs were present (Figure B, arrows). Banding was not pursued because of the extensive nature of the varices.