Dilated submucosal esophageal veins connecting the portal and systemic circulations
Most commonly results from portal hypertension (typically a result of cirrhosis)
Variceal rupture: m...
First indication of varices is often GI bleeding: hematemesis, hematochezia, and/or melena.
Occult bleeding (anemia): uncommon
Underlying history of cirrhosis/liver disease. Variceal bl...
Treat underlying cirrhotic comorbidities.
Variceal bleeding is often complicated by hepatic encephalopathy and infection.
Active bleeding (3)[A]
IV access, hemodynamic resuscita...
Close monitoring of vital signs
Endoscopic variceal ligation, every 1 to 4 weeks, until varices eradicated
If TIPS, repeat endoscopy to assess reb...
Tayyem O, Bilal M, Samuel R, et al. Evaluation and management of variceal bleeding. Dis Mon. 2018;64(7):312–320. [View Abstract on OvidMedline]
Zanetto A, Senzolo M, Ferrarese ...
I85.00 Esophageal varices without bleeding
I85.01 Esophageal varices with bleeding
I85.10 Secondary esophageal varices without bleeding
I85.11 Secondary esophageal varices with bleeding
Thrombocytopenia is the most sensitive marker of increased portal pressure and large esophageal varices.
In acute bleeding, avoid β-blockers.
In acute bleeding, overtransfusion can eleva...
Sign up for a 10-day FREE Trial now and receive full access to all content.