User:Mr. Ibrahem/Esophageal varices
| Mr. Ibrahem/Esophageal varices | |
|---|---|
| Other names | Esophageal varix, oesophageal varices |
 | |
| Gastroscopy image of esophageal varices with prominent cherry-red spots | |
| Specialty | Gastroenterology Hematology |
| Symptoms | Vomiting blood, |red blood per rectum, black blood per rectum[1] |
| Causes | Cirrhosis, portal vein thrombosis, right-sided heart failure, schistosomiasis, alpha-1 antitrypsin deficiency, primary biliary cirrhosis[1] |
| Diagnostic method | Endoscopy[2] |
| Differential diagnosis | Stomach ulcer, stomach cancer, Mallory-Weiss tear[1] |
| Treatment | Intravenous fluids, fresh frozen plasma, antibiotics, octreotide, endoscopic band ligation[1] |
| Frequency | 30% (at cirrhosis diagnosis)[1] |
Esophageal varices are dilated veins under the mucosa in the lower third of the esophagus.[1][3] The first symptom is generally GI bleeding, with vomiting blood, red blood per rectum, or black blood per rectum.[1] Associated symptom may include itchiness, weight lose, and yellowish skin.[1]
The most common cause is cirrhosis, which frequently occur due to alcoholism or viral hepatitis.[1] Other causes include portal vein thrombosis, right-sided heart failure, schistosomiasis, alpha-1 antitrypsin deficiency, and primary biliary cirrhosis.[1] The underlying mechanism involves portal hypertension.[1] Diagnosis is typically by an upper endoscopy.[2]
Treatment of bleeding may include endoscopic band ligation.[1] Other measures may include intravenous fluids, fresh frozen plasma, antibiotics, and octreotide.[1] Esophageal balloon tamponade may be used in cases were other measures are not effective.[1] Longer term management may involved beta blockers or transjugular intrahepatic portosystemic shunt (TIPS).[1] About 5 to 15% of people have bleeding per year.[1] Of those with an episode of bleeding, about 15% die over the next 6 weeks and more than half die within the year.[1]
About 30% of people at the diagnosis of cirrhosis have varices.[1] Males are more commonly affected than females.[1] It is the second most common cause of an upper GI bleed after stomach ulcers.[1] Esophageal varices were described as early as 1859 by Sappey.[4]
References[edit]
- ^ a b c d e f g h i j k l m n o p q r s t Meseeha, M; Attia, M (January 2021). "Esophageal Varices". PMID 28846255.
{{cite journal}}: Cite journal requires|journal=(help) - ^ a b Biecker E, Schepke M, Sauerbruch T (2005). "The role of endoscopy in portal hypertension". Dig Dis. 23 (1): 11–7. doi:10.1159/000084721. PMID 15920321.
- ^ Rubin, Raphael; Strayer, David S.; Rubin, Emanuel, eds. (2012). Rubin's Pathology: Clinicopathologic Foundations of Medicine (6th ed.). Lippincot Williams & Wilkins. p. 612.
- ^ Northup, P (October 2020). "A History of Coagulopathy in Liver Disease: Legends and Myths". Clinical liver disease. 16 (Suppl 1): 56–72. doi:10.1002/cld.954. PMID 33042527.