Zdravljenje in preprečevanje krvavitve varic požiralnika
Therapy and prevention of esophageal varices hemorrhage

slovenian

2005

volume 74, issue 5

Diagnosis   Esophageal And Gastric Varices   Gastrointestinal Hemorrhage   Hypertension, Portal   Physiopathology   Prevention And Control   Therapy   varice

Slovensko zdravniško društvo
(Obvezni izvod spletne publikacije)

Background. Bleeding from esophageal varices is a life threatening situation for a patient with portal hypertension. Esophageal varices are dilated veins in the submucosal layer of the esophagus. The dilatation of submucosal veins is the consequence of elevated pressure in the portal vein. Portal hypertension mostly stems from liver cirrhosis. The mortality rate of patientswith bleeding esophageal varices is high. Therefore, primary-prevention of the first episode of bleeding is very important. Patients with a bleeding esophageal varice must be admitted to hospital. It isvery important that loss in blood volume is substituted with IV infusions even before the admission to hospital. If the patient is bleeding from the upper part of the gastrointestinal tract and has clinical signs of liver cirrhosis and portal hypertension due to the larger probability that the source of the bleeding is the esophageal varix, then even before admission to hospital one can start with IV application of medications for lowering portal vein pressure. This may diminish or even stop the bleesing. After admission anurgent diagnostic esophago-gastro-duodenoscopy should be done as soon as possible in order to determine the source of bleeding. If it is possible, the bleeding should be stopped with endoscopic therapy. After successful endoscopic therapy we continue with the substitution of the loss in blood volume with IV infusion and transfusion and also with IV applications of the medications for lowering portal vein pressure in order to prevent an early re-occurence in bleeding. (Abstract truncated at 2000 characters)

10.04.2014