Oesophageal & Gastric Varices Flashcards Preview

Gastrointestinal > Oesophageal & Gastric Varices > Flashcards

Flashcards in Oesophageal & Gastric Varices Deck (10)
Loading flashcards...
1
Q

What are varices?

A

Dilated sub-mucosal veins that have a tortuous (twisting) course

2
Q

Where in the oesophagus do varcies usually occur?

A

In the lower 1/3rd

3
Q

What problems can varices lead to?

A

Bleeding, which can be life threatening

4
Q

What causes varices in the stomach and oesophagus?

A

Usually portal hypertension, a complication of cirrhosis

Also thrombosis of splenic vein, caused by acute pancreatitis or pancreatic cancer

5
Q

How are oesophageal + gastric varices usually discovered?

A

Patients with cirrhosis are given a gastroscopy routinely, these pick up varices

OR

They present with symptoms

6
Q

What are the clinical features of oesophageal + gastric varices?

A

Vomiting blood
Melaena (passing black, tarry stools)
Maroon stools or frank blood in the stools.

Many present in shock due to profound loss of blood.

7
Q

Investigations of oesophageal + gastric varices?

A

Bloods: low red cell count, low platelets, long INR

Endoscopy: look for the varices and any bleeding

8
Q

Treatment of oesophageal + gastric varices?

A

Treat the underlying cause (cirrhosis, pancreatitis)

If they are in shock, emergency resuscitation - fluids, blood

Gastric variceal obliteration

Variceal ligation or banding:

Sclerotherapy: medicine infected into vein to make it shrink

9
Q

What is INR?

A

International normalised ratio

How long it takes for blood to clot

10
Q

What are the causes of portal hypertension?

A

Pre-hepatic: thrombosis

Hepatic: Cirrhosis, Sarcoidosis

Post-hepatic: Right heart failure, many more