Which complication is most associated with untreated variceal bleeding?

• A. Hypotension
• B. Recurrent embolism
• C. Severe anemia
• D. Cirrhosis

Answer: (C)

Severe anemia is the complication most closely associated with untreated variceal bleeding due to the significant blood loss that occurs during such an event. Variceal bleeding, which typically arises from esophageal or gastric varices in the context of portal hypertension, can lead to rapid and substantial hemorrhage. When this bleeding is not adequately managed or treated, patients lose a considerable amount of blood, resulting in a decrease in red blood cells and hemoglobin levels, leading to anemia. This condition can manifest through symptoms such as weakness, fatigue, and pallor, and, if severe, can pose serious risks to the patient’s health requiring urgent medical attention.

In contrast, while hypotension may occur as a result of significant blood loss, it is a symptom rather than a direct complication arising specifically from untreated variceal bleeding. Recurrent embolism is not typically linked to variceal bleeding but rather to other conditions involving clot formation and can occur under different circumstances. Cirrhosis itself is a chronic liver condition often related to portal hypertension but does not directly represent a complication of acute variceal bleeding; rather, it is more of an underlying cause that leads to the development of varices in the first place.