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Esophageal varices; Other names: Esophageal varix, oesophageal varices: Gastroscopy image of esophageal varices with prominent cherry-red spots and wale signs: Specialty: Gastroenterology, Hematology, Hepatology (liver disease) Symptoms: vomiting blood, passing black stool: Complications: Internal bleeding, hypovolemic shock, cardiac arrest: Causes
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]
Depending on the amount of the blood loss, symptoms may include shock. Upper gastrointestinal bleeding can be caused by peptic ulcers, gastric erosions, esophageal varices, and rarer causes such as gastric cancer. The initial assessment includes measurement of the blood pressure and heart rate, as well as blood tests to determine the hemoglobin.
Signs and symptoms of portal hypertension include: Abdominal swelling and tightness due to ascites, which is free fluid in the peritoneal cavity [1] Vomiting blood (hematemesis) from gastric or esophageal varices; Anorectal varices [8] Increased spleen size (splenomegaly), [1] which may lead to lower platelet counts (thrombocytopenia)
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 ...
Endoscopic image of esophageal varices being ligated with rubber bands. The varix being ligated has a longitudinal red mark on it, termed the wale mark. A wale mark, red wale sign or wale sign is an endoscopic sign suggestive of recent hemorrhage, or propensity to bleed, seen in individuals with esophageal varices at the time of endoscopy.
Gastric varices are dilated submucosal veins in the lining of the stomach, which can be a life-threatening cause of bleeding in the upper gastrointestinal tract.They are most commonly found in patients with portal hypertension, or elevated pressure in the portal vein system, which may be a complication of cirrhosis.
Esophageal varices and gastric varices result from collateral circulation in the esophagus and stomach (a process called portacaval anastomosis). [40] When the blood vessels in this circulation become enlarged, they are called varices. Varices are more likely to rupture at this point. [9] Variceal rupture often leads to severe bleeding, which ...
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