oesophageal varices

Question 1

what are oesophageal varices?

Answer 1

dilated collateral blood vessels that develop as a complication of portal hypertension, usually in the setting of cirrhosis

Question 2

in oesophageal varices, why do the veins easily rupture?

Answer 2

because they are thin and not meant to transport high pressure blood

Question 3

in oesophageal ruptures, what does the rupture cause?

Answer 3

• haematemesis ( coffee vomit)
  —- blood gets ingested and causes melaena

Question 4

what is a differential diagnosis for oesophageal varices?

Answer 4

mallory weiss tear

Question 5

what is the difference between oesophageal varices and mallory Weiss tear?

Answer 5

oesophageal varices- long history of alcoholism and liver history of cirrhosis.

mallory Weiss tear- very acute history of alcoholism increased abdo pressure

Question 6

what is the diagnosis behind oesophageal varices?

Answer 6

oesophagogastroduodenoscopy
- also known upper gi endoscopy

Question 7

what are the symptoms behind oesophageal varices?

Answer 7

• haematemesis
• abdominal pain
• rectal bleeding

Question 8

what are the three types of treatment for oesophageal varices?

Answer 8

1. acutely
2. stop bleed
3. prevent bleed

Question 9

what is the acute treatment for oesophageal varices?

Answer 9

• resuscitation until haemodynamically stable
• blood transfusion

Question 10

what is the treatment to stop the bleed for oesophageal varices?

Answer 10

1. IV Terlipressin
2. variceal banding
3. TIPS- trans jugular intrahepatic portoclaval shunt

Question 11

what is the treatment to prevent bleed for oesophageal varices?

Answer 11

• beta blockers ( non selective) + nitrates
• repeat variceal banding
• last resort- liver transplant