What are bleeding varices?
Varices are dilated blood vessels usually in theesophagusor stomach. They cause no symptoms unless they rupture and bleed.
Bleeding from varices is a life-threatening complication ofportal hypertension. Portalhypertensionis an increase in the pressure within the portal vein (the vein that carries blood from the digestive organs to theliver) due to a blockage of blood flow throughout the liver.
This increased pressure in the portal vein causes the development of large, swollen veins (varices) within the esophagus and stomach. The varices are fragile and can rupture easily, resulting in a large amount of blood loss.
The most common cause of portalhypertensioniscirrhosisof the liver. Cirrhosis is scarring that accompanies the healing of liver injury caused byhepatitis,alcohol, or other less common causes of liver damage. In cirrhosis, thescartissue blocks the flow of blood through the liver and slows its processing functions.
What are the signs and symptoms of bleeding varices?
Symptoms of bleeding varices include:
- Vomitingof blood
- Black, tarry, or bloody凳子
- Low blood pressure
- Rapidheartrate
- Shock(in severe cases)
How Are Bleeding Varices Treated?
Bleeding from varices is a medical emergency and treatment should be immediate. If the bleeding is not controlled quickly, a person may go into shock or die. In severe cases, a person may need to be placed temporarily on a ventilator to prevent thelungs从满血。除了the urgent need to stop the bleeding, treatment is also aimed at preventing future bleeding.
Procedures that help treat bleeding varices include:
- Banding:A procedure performed by agastroenterologistin which small rubber bands are placed directly over the varices. This will stop the bleeding and eradicate the varices.
- Sclerotherapy:A procedure in which a gastroenterologist directly injects the varices with a blood-clotting solution instead of banding them.
- Transjugular Intrahepatic Portosystemic Shunt(TIPS):A radiological procedure in which astent(a tubular device) is placed in the middle of the liver. The stent connects the hepatic vein with the portal vein. This procedure is done by placing a catheter through a vein in the neck. It is performed to relieve thehigh blood pressurethat has built up in the liver.
- Distal Splenorenal Shunt (DSRS):A surgical procedure that connects the splenic vein to the left kidney vein to reduce pressure in the varices and control bleeding.
- Liver transplant:A liver transplant may be done in cases of end-stageliver disease.
- Devascularization:A surgical procedure that removes the bleeding varices. This procedure is done when a TIPS or a surgical shunt is not possible or unsuccessful in controlling the bleeding.
Can Bleeding Varices Be Prevented?
Treating the underlying cause of bleeding varices can help prevent their recurrence and treating liver disease earlier on may prevent their development. Certain medications including the class of heartdrugscalled "beta-blockers" may reduce elevated portal pressure and reduce the likelihood of bleeding. Long-acting nitroglycerines are also used for this purpose.
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Cirrhosis (Liver)
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections.Symptoms include yellowing of the skin (jaundice), itching, and fatigue.
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factor VIII
Factor VIII, human plasma-derived is a specialized protein in blood that plays a role in the clotting (coagulation) process. Human plasma-derived factor VIII is used to maintain the necessary levels of the particular factor in individuals with hemophilia A, a hereditary bleeding disorder caused by deficiency in factor VIII. Common side effects of factor VIII, human plasma-derived include increased factor VIII inhibitors, stinging at the injection site, inflammation at the injection site, chest tightness, headache, fever, chills, lethargy, blurred vision, taste disorder (dysgeusia), and hypersensitivity reactions.
Hepatitis B (HBV, Hep B)
The hepatitis B virus (HBV, hep B) is a unique, coated DNA virus belonging to the Hepadnaviridae family of viruses. The course of the virus is determined primarily by the age at which the infection is acquired and the interaction between the virus and the body's immune system. Successful treatment is associated with a reduction in liver injury and fibrosis (scarring), a decreased likelihood of developing cirrhosis and its complications, including liver cancer, and a prolonged survival.
Hepatitis C (HCV, Hep C)
Hepatitis C is an inflammation of the liver due to the hepatitis C virus (HCV), which is usually spread by blood transfusion, hemodialysis, and needle sticks, especially with intravenous drug abuse. Symptoms of chronic hepatitis include fatigue, fever, muscle aches, loss of appetite, and fever. Chronic hepatitis C may be cured in most individuals with drugs that target specific genomes of hepatitis C.
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The liver is the largest gland and organ in the body. There are a variety of liver diseases caused by liver inflammation, scarring of the liver, infection of the liver, gallstones, cancer, toxins, genetic diseases, and blood flow problems. Symptoms of liver disease generally do not occur until the liver disease is advanced. Some symptoms of liver disease include jaundice, nausea and vomiting, easy bruising, bleeding excessively, fatigue, weakness, weight loss, shortness of breath, leg swelling, impotence, and confusion. Treatment of diseases of the liver depends on the cause.
Liver Disease
Liver disease can be cause by a variety of things including infection (hepatitis), diseases, for example, gallstones, high cholesterol or triglycerides, blood flow obstruction to the liver, and toxins (medications and chemicals). Symptoms of liver disease depends upon the cause and may include nausea, vomiting, upper right abdominal pain, and jaundice. Treatment depends upon the cause of the liver disease.
Low Blood Pressure (Hypotension)
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Nausea and Vomiting
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Portal Hypertension
Portal hypertension is most commonly caused by cirrhosis, a disease that results from scarring of the liver. Other causes of portal hypertension include blood clots in the portal vein, blockages of the veins that carry the blood from the liver to the heart, and a parasitic infection called schistosomiasis. Symptoms of portal hypertension include varices (enlarged veins), vomiting blood, blood in the stool, black and tarry stool, ascites (abnormal fluid collection within the peritoneum, the sac that contains the intestines within the abdominal cavity), confusion and lethargy, splenomegaly or enlargement of the spleen, and decreased white blood cell counts.
Stool Color, Changes, Texture and Form
Stool color changes can very from green, red, maroon, yellow, white, or black. Causes of changes of stool color can range from foods a person eats, medication, diseases or conditions, pregnancy, cancer, or tumors. Stool can also have texture changes such as greasy or floating stools. Stool that has a uncharacteristically foul odor may be caused by infections such as giardiasis or medical conditions.
TIPS (Transjugular Intrahepatic Portosystemic Shunt)
Transjugular intrahepatic portosystemic shunt or (TIPS) is a procedure in which a shunt is placed between the portal vein and the hepatic vein. TIPS is primarily used in individuals who have cirrhosis of the liver. Complications of cirrhosis may result in portal hypertension. There are several types of portosystemic shunts. Two complications of the TIPS procedure include hepatic encephalopathy and/or heart failure.
Hepatitis (Viral Hepatitis A, B, C, D, E, G)
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What Is the Main Cause of Esophageal Varices?
Esophageal varices are enlarged veins in the food pipe (esophagus). This condition develops in people with liver disease.