Oesophagi-Gastric varices Flashcards Preview

Liver + GI > Oesophagi-Gastric varices > Flashcards

Flashcards in Oesophagi-Gastric varices Deck (10):
1

pathogenesis 1:

how does liver fibrosis --> increased CO?

progressive liver fibrosis+ regenerative nodules --> contractile elements in liver's vascular bed

--> portal hypertension --> splanchnic vasodilation --> increased CO

2

pathogenesis 2:

how does increased CO --> O-G varices?

salt + water retention --> increased portal flow

--> collaterals form between portal and systemic system e.g. in lower oesophagus and gastric cardia

--> over time varices develop when portal pressure exceeds a certain level

3

what are varices?

Dilated blood vessels in the esophagus or stomach caused by portal hypertension.

4

how can these cause death?

increased pressure can --> bleeding --> death

(more likely if advanced liver disease or clotting problems)

5

Intra-hepatic causes of portal hypertension

cirrhosis
schistomiasis

6

pre-hepatic cause of portal hypertension

thrombus

7

post-hepatic cause of portal HTN

Budd-Chiara syndrome, right heart failure, constrictive pericarditis, veno-occlusive disease

8

Primary prophylaxis

1. non-selective b-blockade
2. repeat endoscopic banding ligation

9

Secondary prophylaxis (after a 1st vatical bleed)

same as primary
Transjugular intrahepatic porto-systemic shunt for those resistant to banding

10

What is surgical decompression of varices?

balloon tamponade: using balloons to compress gastro-oesophageal varies