In the esophagus there are veins that connect the blood vessels to the liver and a large vein near the heart – the inferior vena cava. Normally blood flows through these veins, which are not seen in the upper digestive endoscopy.
If the pressure in these veins increases, as happens with the cirrhosis nodules that compress these veins, they can swell as varicose veins, which can be seen in the upper digestive endoscopy – see the image below.
Also for this reason (cirrhotic nodules), there is also an enlargement of the spleen in the cirrhosis.
In what diseases do esophageal varicose veins appear?
Varicose veins can appear in the esophagus in several diseases, the most common being:
Patients who have varicose veins in the esophagus usually have liver cirrhosis, but varicose veins can also be in heart disease, large liver tumors or alcoholic liver disease.
Depending on their enlargement, the esophageal varicose veins are classified in 4 degrees, the most serious being those of the 4th degree.
In the absence of treatment and regimen, the size of the esophageal varices may increase progressively, with the risk of their rupture, an extremely serious incident, which can kill half of those with this problem.
symptoms broken esophageal varices
Rupture of the esophageal varices may give the following symptoms:
- Vomiting with clean blood, partially digested or fully digested blood clots (like a cup of coffee)
- Extreme fatigue
- Upper abdomen bloating
- Chest pain
- Coma – can occur in severe forms, by poisoning the patient with residues in the blood in the digestive tract.
- Evacuation of blood through the stool, such as fresh, partially digested blood, clots or completely digested (melena = stool "as a mess", soft, black and glossy), occurs several hours after bleeding, and continues for 48 hours after stopping bleeding; this is the time of passage of the digestive tract from the stomach to the rectum.
Broken esophageal varices – diagnosis
The patient with ruptured esophageal varices usually has known hepatic cirrhosis, and has some of the above symptoms. At his examination, the doctor finds the signs of cirrhosis, the analyzes show changes in liver cirrhosis (anemia, low leukocytes and platelets, lower cholesterol, prothrombin and albumin, etc.), ultrasound may show enlarged spleen, ascites and nodular liver, but the diagnosis of variceal rupture is put through upper digestive endoscopy
Treatment of broken esophageal varices
Treatment of broken esophageal varicose veins is mandatory because the risk of death is high, sometimes the treatment is not effective, even if it is performed correctly and on time.
- Treatment with drugs which tighten the varicose veins (vasoconstrictor) and with them also collect the rupture of the respective vessel
- Evacuation of blood from the digestive tract on the gastric tube or with drugs
- Transfusion of blood
- Varicose veins with a balloon probes see photo
- Treatment surgical (surgical linkage of varicose veins) – is done less today, the other methods can solve the situation
- Treatment by superior digestive endoscopy
- Varicose varicose veins with different substances
- The application of “aGRAPHIC " on varicose veins (endoclips)
- Ligature (bandage) of varicose veins – with elastic rings – watch the movie with maneuver here, this maneuver is done frequently, we have been doing it for over 15 years.
- risk of esophageal varicose veins is the highest in varicose veins III and IV
- Interruption of treatment and diet, associated with alcohol consumption, may increase the risk of esophageal varices rupture
- The chance of survival of a patient with liver cirrhosis and broken esophageal varices is 50%
- The risk of recurrence of bleeding is 5 days after the varicose veins rupture.
- The blood clots shed by the patient resemble the liver so the term "is popular"she shed his liver. " The liver cannot be shed, for the simple reason that it should be eliminated in the stomach through a channel (the coledoc channel) of several millimeters, which is impossible.
- Although the situation is extremely serious, the rapid presentation in a competent medical service can save the patient's life, and we have had dozens of such situations.
If you have broken esophageal varices, what are your chances of surviving?
The theoretical chance of escaping alive in the case of a patient with esophageal variceal rupture is approximately 50-60% with correct treatment.
What diet should you take in case of esophageal varicose veins?
The regime of a particular patient should be personalized, and only the doctor who knows the person (patient) can prescribe it.