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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 ...
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]
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.
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 .
The esophageal branch of the left gastric vein drains into the azygos vein. In cases of portal hypertension, this communication allows for blood to bypass the portal vein and reach systemic circulation. As a result of this anastomosis, development of esophageal and paraesophageal varices is possible. [3]
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 ...
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]