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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.
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 ...
While many causes of lower left abdominal pain can be managed at home through lifestyle changes and over-the-counter remedies, persistent or severe symptoms require professional medical evaluation ...
The esophageal veins drain blood from the esophagus to the azygos vein, in the thorax, and to the inferior thyroid vein in the neck. It also drains, although with less significance, to the hemiazygos vein, posterior intercostal vein and bronchial veins. [citation needed] In the abdomen, some drain to the left gastric vein which drains into the ...
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.
Often blood transfusions are not recommended unless the hemoglobin is less than 70 or 80 g/L. [7] [12] Treatment with proton pump inhibitors, octreotide, and antibiotics may be considered in certain cases. [5] [6] [13] If other measures are not effective, an esophageal balloon may be attempted in those with presumed esophageal varices. [2]
The left gastric vein runs from right to left along the lesser curvature of the stomach. [2] It passes to the esophageal opening of the stomach, where it receives some esophageal veins. [2] It then turns backward and passes from left to right behind the omental bursa. It drains into the portal vein near the superior border of the pancreas. [2]