Oesophageal Varices Flashcards

1
Q

What is the most common cause responsible for oesophageal varices?

A

Portal hypertension

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2
Q

What are oesophageal varices?

A

Dilated submucosal veins found in the lower third of the oesophagus

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3
Q

What is the treatment of oesophageal varices?

A

Endoscopic banding and sclerotherapy

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4
Q

What is sclerotherapy?

A

A medicine is injected into the vessel which causes them to shrink - cyanoacetate

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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
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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

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7
Q

What medication can be used and why?

A

trelipressin and octreotide - reduce portal venous pressure due to splanhnic vasoconstriction

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8
Q

What is the management process?

A
  1. Assess and treat for haemodynamic instability
  2. IV octrotide
  3. Endoscopic ligation or sclerotharapy
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