Esophageal varices (dilation of esophageal veins)

Description The esophagus is th...

Description

The esophagus is the tube that connects the mouth to the stomach. Varices are dilated veins most commonly found near the esophagus or stomach. The most common cause of esophageal varices is scarring of the liver (cirrhosis) from longstanding alcohol abuse. Cirrhosis causes a back-up of blood in the esophageal veins which leads to the development of varices. Bleeding esophageal varices can be life-threatening.

Symptoms

Vomiting blood or a material that resembles coffee grounds, chest pain, breathing problems, fainting, black stools (melena), anemia, fatigue.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical exam will be performed. Additional tests may include: Esophagogastroduodenoscopy (EGD), or esophagram (barium swallow), and blood tests to measure the red blood cell count and the ability to clot blood.

Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP)

Other Specific Tests: Esophagogastroduodenoscopy (EGD), esophagram, protime, partial thromboplastin

Specialists:
Gastroenterology, Vascular and Interventional Radiology

Treatment

For small, non-bleeding varices no treatment may be necessary although close monitoring is recommended. Certain medications (such as beta-blockers and nitrates) may reduce the risk of bleeding. For those that are enlarging, bleeding or appear to be at risk for bleeding, ligation or injection of the varices through the endoscope are the most common initial treatments. A transjugular intrahepatic portosystemic shunt (TIPS) may be performed to reduce the back-up pressure in the esophageal veins. In severe cases of esophageal varices due to cirrhosis, liver transplant is the only effective treatment.