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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.
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 ...
Portal hypertension is defined as increased portal venous pressure, with a hepatic venous pressure gradient greater than 5 mmHg. [3] [4] Normal portal pressure is 1–4 mmHg; clinically insignificant portal hypertension is present at portal pressures 5–9 mmHg; clinically significant portal hypertension is present at portal pressures greater than 10 mmHg. [5]
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.
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.
Gastroesophageal varices may refer to: Esophageal varices, dilated sub-mucosal veins in esophagus; Gastric varices, dilated submucosal veins in the stomach
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.
A study of 15 children, aged 2–12 years old who all had multiple episodes of severe esophageal bleeding varices, and a mean follow-up time of 10 years 4 months, demonstrated 0% mortality and 80% resolution with disappearance of the varices and no evidence of recurrent bleeding.