Esophageal Varices - diagnosis and treatment

Esophageal Varices - diagnosis and treatment

Esophageal Varices - enlarged and weakened veins in the walls of the ESOPHAGUS. Esophageal varices result from PORTAL HYPERTENSION, a condition of impaired BLOOD flow into the LIVER, and are potentially life-threatening should they rupture and HEMORRHAGE. Portal hypertension is a common complication of conditions such as CIRRHOSIS and chronic HEPATITIS that cause SCAR tissue to develop within the liver. Symptoms include GASTROINTESTINAL BLEEDING (VOMITING blood or passing blood in the stool), thirst that increased fluid consumption does not quench, lightheadedness, and mental confusion (hepatic ENCEPHALOPATHY) resulting from toxins the damaged liver can no longer filter from the blood.

ENDOSCOPY (in which the gastroenterologist passes a lighted, flexible scope into the upper gastrointestinal tract) is the primary diagnostic procedure, allowing the gastroenterologist to see the ESOPHAGUS, STOMACH, and DUODENUM (first segment of the SMALL INTESTINE). The endoscopy reveals the swollen veins, which the gastroenterologist can ligate (band or tie off) or inject with a DRUG to clot the blood inside the VEIN. Bleeding esophageal varices require emergency treatment, nearly always endoscopic treatment to stop the bleeding. A radiologist can do an interventional procedure called TIPPS (transjugular intrahepatic portosystemic shunt) to decrease portal pressure and stop variceal bleeding. When other efforts are not successful a surgeon may place a shunt (tube that reroutes the flow of blood) to improve blood flow into the liver, relieving the pressure blood encounters when trying to enter the liver. Usually the end treatment for esophageal varices is LIVER TRANSPLANTATION.

See also HYPOTENSION; LIVER FAILURE.

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The Gastrointestinal System

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