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Bleeding esophageal varices
DefinitionBleeding esophageal varices result from dilated veins in the walls of the lower part of the esophagus and sometimes the upper part of the stomach.
Causes, incidence, and risk factors
Bleeding varices are a life-threatening complication of portal hypertension (increased blood pressure in the portal vein caused by liver disease ). Increased pressure causes the veins to balloon outward. The vessels may rupture, causing vomiting of blood and bloody stools or tarry black stools . If a large volume of blood is lost, signs of shock will develop. Any cause of chronic liver disease can cause bleeding varices.
Signs and tests
Tests to localize bleeding and detect active bleeding:
Tests to visualize the varices:
The objective of therapy is to stop acute bleeding as soon as possible and manage persistent varices with medical and procedural therapies. Bleeding must be controlled quickly to prevent shock and death. If massive bleeding occurs, the patient may be placed on a ventilator to protect the airway and prevent blood from going down into the lungs.
Bleeding recurs frequently without treatment. Bleeding esophageal varices are a serious complication of liver disease and carry a poor prognosis (probable outcome). Liver transplantation should be considered for patients with bleeding varices from liver disease.
Calling your health care provider
Call your health care provider if significant episodes of vomiting blood or black tarry stools occur.
Treatment of the underlying causes of liver disease may prevent bleeding. Preventive treatment of varices with medications such as beta blockers or with endoscopic banding may be helpful in preventing bleeding. Evaluation for liver transplantation should also be considered.
Update Date: 5/5/2002Andrew J. Muir, M.D. M.H.S., Division of Gastroenterology, Duke University Medical Center, Durham, NC. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT