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Esophageal Varices Reviewed 5/2013

Avani Sinha, MD, Edward Feller, MD
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BASICS

  • Description
  • Epidemiology
  • Risk Factors
  • General Prevention
  • Pathophysiology
  • Etiology
  • Associated Conditions

DIAGNOSIS

  • History
  • Physical Exam
  • Tests
  • Differential Diagnosis

TREATMENT

  • Medication (Drugs)
  • Additional Treatment
  • Surgery
  • In-patient Considerations

ONGOING CARE

  • Follow-Up Recommendations
  • Patient Education
  • Prognosis
  • Complications
The following is an excerpt....
BASICS
Description
  • Dilated veins in the distal esophagus that connect the portal and systemic circulations
  • Result from resistance to portal blood flow and increased portal venous blood inflow as a direct consequence of portal hypertension
  • Cirrhosis leads to increased pressure and turbulent flow; superficial location of distal esophageal veins make them susceptible to rupture, producing major GI bleeding with high morbidity, mortality.
Epidemiology
Incidence

1-year rate of 1st variceal bleeding is ~5% for small varices, 15% for large varices (1).

ALERT: Pediatric Considerations
Portal hypertension commonly complicates chronic liver disease in children. Incomplete data on screening, endoscopic treatment, β-blockers use (2)
Prevalence
  • Esophageal varices in patients with cirrhosis (correlating with disease severity): 50%
  • Patients with esophageal varices who ...

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See Also
Images >
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varicosis: in a healthy vein the valves allow blood to travel toward heart (A) while keeping blood from flowing back away from heart (B); valves in varicose veins (C) no longer function properly, thus allowing blood to travel back toward extremities, (D) photograph of leg with varicose veinsCredit: NA
Procedures & PT >