Varicose Veins of the Esophagus

Esophageal Varices: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes [jaundice (yellowing of the skin); tendency to hematoma (bruising) due to impaired clotting; hepatic skin signs: Dupuytren’s contracture (synonyms: Dupuytren’s contracture, Dupuytren’s disease) – nodular, cord-like … Esophageal Varices: Examination

Esophageal Varices: Test and Diagnosis

Laboratory parameters of the 1st order – obligatory laboratory tests. Small blood count [thrombocytopenia (lack of platelets); anemia (anemia)] Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT) [only mildly elevated or normal], glutamate dehydrogenase (GLDH), gamma-glutamyl transferase (γ-GT, gamma-GT; GGT), alkaline phosphatase, bilirubin [bilirubin ↑] CHE (cholinesterase) [CHE ↓, as a sign … Esophageal Varices: Test and Diagnosis

Esophageal Varices: Drug Therapy

Therapeutic Targets Prevention of complications and sequelae such as esophageal variceal hemorrhage (bleeding from veins in the wall of the esophagus) In esophageal variceal bleeding: hemostasis. Avoidance of sepsis (blood poisoning). Avoidance of recurrent bleeding (bleeding again). Therapy recommendations Primary prophylaxis: Objective: avoid first esophageal variceal bleeding; risk of first esophageal variceal bleeding is approximately … Esophageal Varices: Drug Therapy

Esophageal Varices: Diagnostic Tests

Obligatory medical device diagnostics. Esophagogastroduodenoscopy (OGD) – endoscopy of the esophagus (food pipe), gastroesophagus (stomach), and upper part of the duodenum (duodenum); for status assessment. Esophageal varices stage I: close monitoring if no risk indicators are present. Esophageal varices stage II and III: endoscopic therapy (variceal ligation; so-called rubber band ligation) in the context of … Esophageal Varices: Diagnostic Tests

Esophageal Varices: Surgical Therapy

Acute esophageal variceal hemorrhage The following measures may be considered to stop acute esophageal variceal hemorrhage: Rubber band ligation (GBL) – This is performed endoscopically and is considered the method of choice. It is associated with significantly fewer complications than variceal sclerotherapy. Variceal sclerotherapy (variceal sclerotherapy) – This involves injecting a sclerosant (hardening agent), such … Esophageal Varices: Surgical Therapy

Esophageal Varices: Prevention

To prevent esophageal varices (varicose veins of the esophagus), attention must be paid to reducing individual risk factors. Behavioral risk factors Pleasure food consumption Alcohol (woman: > 40 g/day; man: > 60 g/day). Primary prophylaxis Primary prophylaxis aims to prevent a first esophageal variceal bleed. The risk of first esophageal variceal bleeding is approximately 30%. … Esophageal Varices: Prevention

Esophageal Varices: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate esophageal varices (varicose veins of the esophagus): Main symptoms Feeling of pressure and fullness in the upper abdomen. Secondary symptoms Anemia (anemia) Skin pallor Fatigue and weakness Symptoms of portal hypertension Ascites (abdominal dropsy) Liver skin signs: such as: Dupuytren’s contracture (synonyms: Dupuytren’s contracture, Dupuytren’s disease) – nodular, … Esophageal Varices: Symptoms, Complaints, Signs

Esophageal Varices: Causes

Pathogenesis (development of disease) Esophageal varices are the result of portal hypertension (portal hypertension: increase in pressure in the portal vein > 12 mmHg), as often occurs in the setting of liver cirrhosis (liver shrinkage).The portal vein (vena portae) collects blood from the veins of the unpaired abdominal organs (gastrointestinal tract/gastrointestinal tract and spleen) and … Esophageal Varices: Causes

Esophageal Varices: Therapy

In addition to prophylaxis of esophageal variceal hemorrhage, treatment of the underlying disease is of primary importance. General measures Alcohol abstinence (complete abstinence from alcohol). Nicotine restriction (refrain from tobacco use) – smoking promotes fibrosis (proliferation of connective tissue fibers) of the liver. Conventional non-surgical therapy methods For acute esophageal variceal hemorrhage: Monitoring or observation … Esophageal Varices: Therapy

Esophageal Varices: Medical History

Medical history represents an important component in the diagnosis of esophageal varices (varicose veins of the esophagus). Family history Is there a high incidence of liver disease in your family? Social history Current medical history/systemic history (somatic and psychological complaints). What symptoms have you noticed? How long have these changes been present? Do you often … Esophageal Varices: Medical History

Esophageal Varices: Or something else? Differential Diagnosis

Mouth, esophagus (esophagus), stomach, and intestines (K00-K67; K90-K93). Erosive gastritis (gastric mucosal erosions). Upper gastrointestinal bleeding (GIB). Mallory-Weiss syndrome – clustered longitudinal (elongated) tears of the mucosa (mucous membrane) and submucosa (submucosal connective tissue) of the esophagus occurring in alcoholics, which may be associated with potentially life-threatening hemorrhage of the outer esophagus and/or the entrance … Esophageal Varices: Or something else? Differential Diagnosis

Esophageal Varices: Complications

The following are the most important diseases or complications that may be contributed to by esophageal varices (varicose veins of the esophagus): Blood, blood-forming organs – Immune system (D50-D90). Iron deficiency anemia (anemia due to iron deficiency). Cardiovascular system (I00-I99) Hypovolemic shock (volume-deficiency shock) associated with esophageal variceal hemorrhage. Esophageal variceal hemorrhage – it represents … Esophageal Varices: Complications