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