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Esophageal varices may lead to severe upper gastrointestinal bleeding. In emergency situations, care is directed at stopping blood loss, maintaining plasma volume, correcting disorders in coagulation induced by cirrhosis, and appropriate use of antibiotics such as quinolones or ceftriaxone .
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 ...
Generally, diseases outlined within the ICD-10 codes I80-I89 within Chapter IX: Diseases of the circulatory system should be included in this category. Subcategories This category has only the following subcategory.
It is a temporary measure: ulceration and rupture of the esophagus and stomach are recognized complications. [4] [5] A related device with a larger gastric balloon capacity (about 500 ml), the Linton–Nachlas tube, is used for bleeding gastric varices. It does not have an esophageal balloon.
This is typically in addition to endoscopic banding or sclerotherapy for the varices. [21] If this is sufficient then beta blockers and nitrates may be used for the prevention of re-bleeding. [21] If bleeding continues then balloon tamponade with a Sengstaken-Blakemore tube or Minnesota tube may be used in an attempt to mechanically compress ...
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]
Unlike esophageal varices, rectal varices are less prone to bleeding, are less serious when a bleed does occur, and are easier to treat because of the more accessible location. [9] However, in some cases, rectal varices can result in severe bleeding. [10] Typically, treatment consists of addressing the underlying portal hypertension.
Minnesota four-lumen tube, with esophageal and gastric balloons, and esophageal and gastric aspirates. Balloon tamponade is considered a bridge to more definitive treatment modalities, and is usually administered in the emergency department or in the intensive-care unit setting, due to the illness of patients and the complications of the procedure.