Acute Variceal Bleeding Flashcards
1
Q
What are varices and what are they caused by?
A
Varices are dilated vessels in oesophagus or stomach which are caused by portal hypertension
2
Q
What causes varices?
A
Portal hypertension
3
Q
When varices rupture?
Factor which increases the risk?
A
Potentially life threatening
Presence of cirrhotic disease increased the risk of rupture
4
Q
How does it present?
A
With the symptoms of a GI bleed
- Palmar erythema
- Leukonychia
- Spider naevi
- Jaundice
- Ascites
5
Q
How is an acute variceal bleed diagnosed?
A
Suspected when
-Bleeding when there is a known history of cirrhosis with varices, chronic alcohol XS, chronic viral hepatitis , AI liver disease, sepsis
6
Q
Aims of treatment?
A
- Resuscitate
- Achieve haemostasis
- Prevent bleeding complications
- prevent liver function deterioration
- Prevent early re-bleeding
7
Q
Treatment?
A
- Terlipressin (vasopressin analogue) bolus (renal perfusion)
- Endoscopic variceal ligation (banding)
- Sendstaken- Blakemore balloon (if banding fails)
