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Splenic vein thrombosis is a rare condition that causes esophageal varices without a raised portal pressure. Splenectomy can cure the variceal bleeding due to splenic vein thrombosis. [citation needed] Varices can also form in other areas of the body, including the stomach (gastric varices), duodenum (duodenal varices), and rectum (rectal ...
Procedures (such as TIPS for variceal bleeding) may be used. Recurrent or refractory bleeding may lead to need for surgery, although this has become uncommon as a result of improved endoscopic and medical treatment. Upper gastrointestinal bleeding affects around 50 to 150 people per 100,000 a year.
The Sugiura procedure was originally developed to treat bleeding esophageal varices and consisted mainly of an esophagogastric devascularization. It was developed in Japan in 1973 [ 1 ] as a nonshunting technique that achieved variceal bleeding hemostasis by interrupting the variceal blood flow along the gastroesophageal junction.
Despite treatment, re-bleeding occurs in about 7–16% of those with upper GI bleeding. [3] In those with esophageal varices, bleeding occurs in about 5–15% a year and if they have bled once, there is a higher risk of further bleeding within six weeks. [13] Testing and treating H. pylori if found can prevent re-bleeding in those with peptic ...
Patients with portal hypertensive gastropathy may experience bleeding from the stomach, which may uncommonly manifest itself in vomiting blood or melena; however, portal hypertension may cause several other more common sources of upper gastrointestinal bleeding, such as esophageal varices and gastric varices. On endoscopic evaluation of the ...
Treatment is directed towards decreasing portal hypertension itself or in the management of its acute and chronic complications. [7] Complications include ascites, spontaneous bacterial peritonitis , variceal hemorrhage, hepatic encephalopathy , hepatorenal syndrome , and cardiomyopathy .
TIPS is a life-saving procedure in bleeding from esophageal or gastric varices. A randomized study showed that the survival is better if the procedure is done within 72 hours after bleeding. [2] TIPS has shown some promise for people with hepatorenal syndrome. [3] It may also help with ascites. [4]
The use of the tube was originally described in 1950, [1] although similar approaches to bleeding varices were described by Westphal in 1930. [2] With the advent of modern endoscopic techniques which can rapidly and definitively control variceal bleeding, Sengstaken–Blakemore tubes are rarely used at present. [3]