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Axial CT showing esophageal varices in liver cirrhosis with portal hypertension. Dilated submucosal veins are the most prominent histologic feature of esophageal varices. The expansion of the submucosa leads to elevation of the mucosa above the surrounding tissue, which is apparent during endoscopy and is a key diagnostic feature.
Cirrhosis, also known as liver cirrhosis or hepatic cirrhosis, chronic liver failure or chronic hepatic failure and end-stage liver disease, is an acute condition of the liver in which the normal functioning tissue, or parenchyma, is replaced with scar tissue and regenerative nodules as a result of chronic liver disease.
Bleeding is typically divided into two main types: upper gastrointestinal bleeding and lower gastrointestinal bleeding. [2] Causes of upper GI bleeds include: peptic ulcer disease, esophageal varices due to liver cirrhosis and cancer, among others. [3] Causes of lower GI bleeds include: hemorrhoids, cancer, and inflammatory bowel disease among ...
The first is the use of beta-blockers, which reduce portal pressures. Non-selective beta blockers (such as propranolol and nadolol) have been used to decrease the pressure of the portal vein in patients with esophageal varices, and have been shown to regress portal hypertensive gastropathy that has been worsened by medical treatment of varices. [5]
Liver failure is the inability of the liver to perform its normal synthetic and metabolic functions as part of normal physiology. Two forms are recognised, acute and chronic (cirrhosis). [ 1 ] Recently, a third form of liver failure known as acute-on-chronic liver failure ( ACLF ) is increasingly being recognized.
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]
Vital signs, in order to determine the severity of bleeding and the timing of intervention; Abdominal and rectal examination, in order to determine possible causes of hemorrhage; Assessment for portal hypertension and stigmata of chronic liver disease in order to determine if the bleeding is from a variceal source.
[47] [48] Alcohol-related liver disease accounts for about 4.5% of liver-related deaths globally, underscoring the substantial burden of alcohol misuse. [49] Viral hepatitis, primarily hepatitis B and hepatitis C, remains a leading cause of liver cirrhosis and liver cancer worldwide, despite advances in antiviral therapies and vaccination ...
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