Esophageal varices

Description

The esophagus is the tube that connects the mouth to the stomach.Varices are dilated veins located nearby the esophagus and the stomach. The most frequent cause of esophageal varices are scares on the liver (cirrhosis) caused from longlasting alcoholism. Cirrhosis causes a blood to come back in the esophageal veins which leads to the development of varices. Bleeding of the esophagus can be life-threatening.

Symptoms

Vomiting blood or materias that look like coffee grounds, chest pain, breathing troubles, dizziness, dark stool (melena), anemia, tiredness.

Overview

Anamnesis and physical examination will be done. Additional tests may include:Esophagogastroduodenoscopy (EGD) or esophagram (barium contrast) and blood analysis to measure the amount of red blood cells and coagulation capability.

Tests

Complete blood count (CBC) and comprehensive metabolic panel (CMP).

Additional analyses

Esophagogastroduodenoscopy (EGD), esophagram,prothrombin time, activated partial thromboplastin.

Specialists

Gastroenterology and Vascular and Interventional Radiology

Therapy

No treatment may be necessary for small, non-bleeding varices, although close monitoring is recommended. Some medicines (such as beta-blockers and nitrates) may reduce the risk of bleeding. Ligation or injection of the varices through the endoscope are the most frequent initial treatments for those that are enlarging, bleeding or seem to be at risk for bleeding. A transjugular intrahepatic portosystemic shunt (TIPS) may be performed to reduce the reversal pressure in the veins of esophagus. In more severe cases, liver transplant is the only effective treatment.