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Esophageal varices are extremely dilated sub-mucosal veins in the lower third of the esophagus. [1] They are most often a consequence of portal hypertension, [2] commonly due to cirrhosis. [3] People with esophageal varices have a strong tendency to develop severe bleeding which left untreated can be fatal.
People are usually stratified into having either variceal or non-variceal sources of upper gastrointestinal hemorrhage, as the two have different treatment algorithms and prognosis. [citation needed] The causes for upper gastrointestinal hemorrhage include the following: Esophageal causes (gastrorrhagia): Esophageal varices; Esophagitis ...
Esophageal inflammation and erosive disease are the next most common causes. [3] In those with liver cirrhosis, 50–60% of bleeding is due to esophageal varices. [3] Approximately half of those with peptic ulcers have an H. pylori infection. [3] Other causes include Mallory-Weiss tears, cancer, and angiodysplasia. [2]
Banding is a medical procedure which uses elastic bands for constriction. Banding may be used to tie off blood vessels in order to stop bleeding, as in the treatment of bleeding esophageal varices. [1] The band restricts blood flow to the ligated tissue, so that it eventually dies and sloughs away from the supporting tissue.
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 ...
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]
Treatment (banding/sclerotherapy) of esophageal varices; Injection therapy (e.g., epinephrine in bleeding lesions) Cutting off of larger pieces of tissue with a snare device (e.g., polyps, endoscopic mucosal resection) Application of cautery to tissues; Removal of foreign bodies (e.g., food) that have been ingested
Esophagitis, esophageal varices, gastritis, cirrhosis or gastric ulcers for example, may bleed and produce coffee-ground vomitus. When unaccompanied by melena, hematemesis or a fall in hemoglobin with corresponding urea rises and creates an unstable reaction, and other causes of coffee ground vomitus need to be elucidated; for example, gastric stasis, bowel obstruction or ileus, that can cause ...
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