Esophageal varices

CLINICAL OVERVIEW - Esophageal Varices TERMINOLOGY CLINICAL CLARIFICATION o 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. CLASSIFICATION

Introduction Esophageal varices are abnormally enlarged veins usually located in the submucosa of the lower esophagus and are caused when there is an obstruction of the portal venous circulation. Esophageal varices are most common in individuals with liver diseases and in most circumstances can be life threatening. It is imperative that we diagnose esophageal varices in a timely manner to decrease complications. Pathophysiology and Concept Pathophysiology Esophageal varices is usually always caused

Currently endoscopy has been the gold standard modality in identifying esophageal varices 108[13]. However, many studies have identified many noninvasive markers predicting the presence and grading of esophageal varices 109,110[14,15]. Many studies have revealed that multiple factors can be used in prediction of the presence of esophageal varices like splenomegaly, 111-113[16-18] spider nevi, ascites114[19]Child Turcotte Pugh grading system113,114[18,19] platelet count 114-118[19-23] portal vein

bleeding or even thrombotic complications (12). Non- PVT group At presentation (N=26) After 6 months (N=26) p No % No % Gastropathy Gastropathy grade I 3 11.53 4 15.3 0.6 Gastropathy grade II 4 15.38 3 11.5 Gastropathy grade III 3 11.53 0 0 Esophageal varices OV I 2 7.69 3 11.5 OV II 3 11.53 3 11.5 0.09 OV III 5 19.23 2 7.6 OV IV 4 15.38 1 3.8 ISSN 2320-5407 International Journal of Advanced Research (2015), Volume 3, Issue 12, 1539 – 1548 1545 In our study as regards presence of co- morbid factors

reduced in cirrhotic as they are metabolized by the liver and associated with adverse effects of prolonged use. Keywords Proton pump inhibitors, liver cirrhosis, peptic ulcer, H. pylori, esophageal band ligation. Abbreviations P.P.I: proton pump inhibitors. EVS: esophageal variceal Sclerotherapy. EVL: esophageal variceal ligation. HE: hepatic encephalopathy. SBP: spontaneous bacterial peritonitis. CDI: Clostridium difficile infection. PHG: portal hypertensive gastropathy. GERD: gastroesophageal

to investigate the relation of these hormonal alterations to esophageal varices, portal hypertensive gastropathy (PHG) and degree of liver dysfunction in Egyptian cirrhotic patients with portal hypertension. Material and methods: study included 124 cirrhotic patients and 62 controls, patients were stratified into: group I (62 patients) with esophageal varices and group II (62 patients) with portal hypertensive gastropathy without varices, each group was classified according to presence or absence

airway clearance related to aspiration of blood (Ackley, B., Ladwig, G., 2011) Bleeding often stop spontaneously, but if it does not, a Sengstaken-Blakemore or Minnesota tube is inserted to provide constant pressure at the source of bleeding of the varices by using a balloon tamponade. For continued bleeding, a nasogastric tube may be inserted and connected to continuous low suction with periodic lavages. Intra-arterial infusion of vasopressin or

all › 41 Reads Download Add supplementary resources Recommend Portal vein thrombosis in patients with liver cirrhosis: insights to risk factors, clinical presentation and outcome Article in International Journal of Advanced Research 3(12):1539-1548 · December 2015 1st Afifi F Afifi 2nd Osama Basha 6.99 · Zagazig University + 1 3rd Fady Maher Zagazig University Last Raghda Abd Ellatif Hafez 16.2 · Faculty of medicine/Zagazig University.www.zu.edu.eg Show more authors 3 elements are still missing

Portal vein thrombosis in patients with liver cirrhosis: insights to risk factors, clinical presentation and outcome Afifi F. Afifi 1, Osama M. Basha 1 , Fady M. Wadea 1, Abdelaziz E. Samack 2, Raghda Abd-elatif Hafez 3 1- GIT and hepatology unit, Internal Medicine department, Faculty of Medicine, Zagazig University. 2- Radiology department, Faculty of Medicine, Zagazig University. 3- Microbiology&Immunology department, Faculty of Medicine, Zagazig University. EGYPT Manuscript Info Abstract

Page 8 Page 9 ISSN 2320-5407 International Journal of Advanced Research (2015), Volume 3, Issue 12, 1539 –15481546INR levels were less in PVT group than control group but in patients with early stages of liver cirrhosis, no differences in their levels was found between the 2 groups. Therefore, patients with advanced liver cirrhosis and less prolonged coagulation parameters appear to carry a higher risk of PVT compared with patients with advanced liver cirrhosis