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Esophageal varices seven days after banding, showing ulceration at the site of banding The upper two thirds of the esophagus are drained via the esophageal veins , which carry deoxygenated blood from the esophagus to the azygos vein , which in turn drains directly into the superior vena cava .
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 .
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]
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 ...
Gastric varices are dilated submucosal veins in the lining of the stomach, which can be a life-threatening cause of bleeding in the upper gastrointestinal tract.They are most commonly found in patients with portal hypertension, or elevated pressure in the portal vein system, which may be a complication of cirrhosis.
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 ...
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 ...
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]