Essay On Esophageal Varices

Ans)- scarring (cirrhosis) of the liver is the most common cause of esophageal varices. The scarring cuts down on blood flowing through the liver. As a result, more blood flows through blood flows through the veins of the esophagus. The extra blood flow causes the veins in the esophagus to balloon outward.

When the central scar is large the conspicuity of the lesion increases (34). In some cases, a halo might be present around the lesion. It is thought that this halo represents compressed hepatic parenchyma or vessels and is more prominent when the lesion is located within a liver with steatosis. Contrast-enhanced US has been reported more accurate in detecting FNH. With using contrast materials an enhancement is possible and prominent feeding vessels may be seen in the arterial phase (34). In the portal venous phase, in contrast to hemangioma and hepatocellular adenoma, a centrifugal filling is seen and the enhancement is sustained in the portal venous phase (opposite to hepatocellular adenoma)

Define the stage of the disease is very important for diagnosis, treatment, and follow-up . There are many ways for assessing the degree of liver fibrosis. Liver biopsy was the gold standard for assessing liver fibrosis, but now it is of limited value because it is so invasive, its high cost, poor acceptance, risk of complications, and intra/inter-observer variability (Poynard et al.,2007). During the different stages of fibrosis , there are excessive amounts of extracellular matrix of various biomarkers changed and new biomarkers appeared in the serum (Jarcuska et al.,2010 and Baranova et al. 2011).

Sampling: Under complete aseptic conditions, 8 ml of venous blood were collected .Each blood sample was divided and divided as follows: Tube A :4 ml were collected in plain tube, left to clot at 37ºC ,then centrifuged ,clear sera were separated and divided into 3 aliquots; the first one was used to determine liver function tests(total &direct bilirubin, AST, ALT, GGT,ALP, total protein and albumin) by using AU640 autoanalyzer. The second was used for measurement of alpha feto- protein by enzyme-linked immunosorbent assay using Human AFP ELISA kits supplied by Glory Science(Immunospec Corporation, 7018 Owensmouth Ave. Suite 103 Canoga Park, CA, 91303) and the third one used for detection of hepatitis markers antibodies (HBsAg, and HCV antibody) by direct sandwich assay using the ELISA Kit supplied by Adltis, Germany. The specimens were kept frozen at -20 ˚C until the time of assay, Tube B: 2 ml were collected in a sterile sodium citrate vacutainer tubes for immediate assay of prothrombin time, concentration and INR and Tube C: 2ml were collected in sterile vacutainer tubes containing EDTA for DNA extraction.

In the presented case scenario, we have Mr. Gil Martin who is a 55-year-old Hispanic male. He comes in to the clinic today with complaints of weakness, fatigue, and loss of appetite. A student nurse will be precepting your assessment of Mr. Martin and when collecting subjective and objective data it is important to pay close detail to all findings. Ultimately this patient was diagnosis with cirrhosis, which is an abnormal liver condition that leads to irreversible scarring of the liver (National Institute of Health [NIH], 2017), so during assessment we should pay attention to details leading to this diagnosis.

Initial liver biopsy is recommended for assessment of the inflammatory activity and the severity of fibrosis, which is useful for making therapeutic decision. The work-up shows that interface and zone 1 lobular hepatitis is the hallmark with the characteristic lymphoplasmacytic infiltrate, typically prominent portal and periportal (in case of bridging necrosis or cirrhosis) inflammation which generally spares the bile ducts, and acinar transformation of hepatocytes (rosettes formation). Plasma cells may not be dominant but prominent inflammatory cells only at the interface. The non-specificity of histological findings to autoimmune hepatitis should always be remembered, and the absence of plasma cells does not preclude the diagnosis. Meanwhile,

What is Barrett’s esophagus? It is a metaplasia of the glandular changes in the lower distal esophagus. This diagnosis is related to a high incidence of esophageal adenocarcinoma. Therefore for surveillance and screening a 4 quadrant biopsy is obtained. Furthermore, this relates in the ability to focus subsequent biopsies on

Varicose veins are veins that are bulging, enlarged and swollen. They can be itchy and painful and unsightly.

Chronic liver diseases and liver biopsy. Chronic liver diseases encompass many different causes, including viral infections, nonalcoholic fatty liver disease (NAFLD), alcohol abuse, primary sclerosing cholangitis, primary hemochromatosis, and autoimmune disease. All of these precipitate chronic damage to the liver via necroinflammation and subsequent cellular injury and accumulation of extracellular matrix (ECM) proteins distorting the hepatic architecture by forming hepatic fibrosis with abnormal collagen deposition. Without treatment, the eventual development of cirrhosis (the end stage of fibrosis) can accelerate to hepatocellular dysfunction, hepatic insufficiency, portal hypertension, and hepatocellular carcinoma (HCC), thus

All ERCP procedures were performed by experienced endoscopists using the Pentax lateral view endoscope ED-3440T and ED-3485T. Patients were placed in prone position and sedated with midazolam and propofol in conjunction with a topical anesthetic applied to the posterior oropharynx under the supervision of an anesthesiologist. EPLBD was done with a balloon dilator (controlled radial expansion [CRE] dilation balloon; maximum diameter 15 or 18 mm; length 5 cm; Microvasive, Boston Scientific Corp., Ireland) between 10 and 16 mm in diameter without preceding ES. After diagnostic cholangiography, a guidewire (0.025_0.035inch, Boston Scientific Corp., Natick, MA, USA) was passed through the diagnostic cannula into the bile duct. The balloon dilator

Esophageal varices are abnormal, enlarged veins in the lower part of the esophagus. Esophageal varices develop when normal blood flow to the liver is obstructed by scar tissue in the liver or a clot. Seeking a way around the blockages, blood flows into smaller blood vessels that are not designed to carry large volumes of blood. The vessels may leak blood or even rupture, causing life-threatening bleeding.

One of these symptoms is jaundice, which is characterized by yellowish skin and eyes because of an inability of the liver to remove bilirubin from the blood. Patient with cirrhosis also suffering from itching, due to deposited bile's products in the skin. This patient also suffers from accumulation of fluid in legs that is called edema. As a result of the blockage of blood flow via the liver, fluid accumulation in abdomen which is worsen by the decrease in protein production. Other symptoms include fatigue, weakness, loss of appetite, weight loss and nausea. As the disease progress, complications may develop ,such as varices that happens with cirrhosis patient when the blood flow through the liver slows, so the blood from intestine go back to the vessels of the stomach and esophagus, these vessels are not meant to carry this much of blood so they dilate (varices), with increasing

Esophageal cancer is a malignant tumor that develops in the esophagus. Although it is not clear as of what causes esophageal cancer. The major cause is DNA mutation of the cells in the esophagus that makes them grow rapidly and divide without inhibition. If not detected in the early stages these cells spread to the adjacent tissues and eventually spread throughout the body.

I understand that you are going through a series of frequent and agonizing heartburns. The heartburn you are encountering is from eating substantial dinners during the evening. The physician examined you with an endoscope, which is a thin and flexible tube equipped with an optical device (DeBruyne and Pinnap, 2014, p.494). The results of the examination indicates evidence of a medical complication of reflux esophagitis and esophageal stricture. According to DeBruyne and Pinna (2014) , the term reflux esophagitis is inflammation in the esophagus related to the reflux acid stomach contents (p.493). Due to the inflammation in the esophagus, it begins to narrow and tighten, which is what we call esophageal stricture.

Intervention for the problem is adoption of statin therapy as the remedy to help in the reduction of cardiovascular disease related mortality rates. The management of the disease is highly beneficial to the people most vulnerable to developing the disease. The efficient monitoring of the liver function tests among the patients is highly recommended to ensure the proper management among the patients experiencing the liver disease (Shehata et al, 2015).