Oesophageal Varices Flashcards
1
Q
What is the most common cause responsible for oesophageal varices?
A
Portal hypertension
2
Q
What are oesophageal varices?
A
Dilated submucosal veins found in the lower third of the oesophagus
3
Q
What is the treatment of oesophageal varices?
A
Endoscopic banding and sclerotherapy
4
Q
What is sclerotherapy?
A
A medicine is injected into the vessel which causes them to shrink - cyanoacetate
5
Q
What would you do in a case of refractory bleeding?
A
- Balloon tamponade used as bridging for further endoscopic treatment
- Transhepatic portosystemic shunt
- Liver transplant
6
Q
What would be used for a complicated bleed?
A
Sugiura procedure - transection of blood vessels that supply the upper portion of the oesophagus , also used for splenectomy
7
Q
What medication can be used and why?
A
trelipressin and octreotide - reduce portal venous pressure due to splanhnic vasoconstriction
8
Q
What is the management process?
A
- Assess and treat for haemodynamic instability
- IV octrotide
- Endoscopic ligation or sclerotharapy
