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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.
This peri-cellular chickenwire fibrosis leads to portal hypertension or an elevated blood pressure in the portal veins that drain blood from the intestines to the liver. [7] This causes many of the sequelae of chronic liver disease including esophageal varices (with associated variceal bleeding), ascites and splenomegaly.
Liver cirrhosis makes it hard for blood to flow in the portal venous system. [38] This resistance creates a backup of blood and increases pressure. [38] This results in portal hypertension. Effects of portal hypertension include: Ascites is a build-up of fluid in the peritoneal cavity in the abdomen [39] An enlarged spleen in 35–50% of cases [6]
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 others. [2] [1] Small amounts of bleeding may be detected by fecal occult blood test. [1]
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 ...
Esophagitis, esophageal varices, gastritis, cirrhosis or gastric ulcers for example, may bleed and produce coffee-ground vomitus. When unaccompanied by melena, hematemesis or a fall in hemoglobin with corresponding urea rises and creates an unstable reaction, and other causes of coffee ground vomitus need to be elucidated; for example, gastric stasis, bowel obstruction or ileus, that can cause ...
Alcoholic liver disease (ALD), also called alcohol-related liver disease (ARLD), is a term that encompasses the liver manifestations of alcohol overconsumption, including fatty liver, alcoholic hepatitis, and chronic hepatitis with liver fibrosis or cirrhosis. [1] It is the major cause of liver disease in Western countries, and is the leading ...
The causes for portal hypertension are classified as originating in the portal venous system before it reaches the liver (prehepatic causes), within the liver (intrahepatic) or between the liver and the heart (post-hepatic). The most common cause is cirrhosis (chronic liver failure). Other causes include: [1] [10] [11] Prehepatic causes
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