Gastric varices
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Gastric varices are dilated submucosal veinsin the stomach.
Gastric varices are typically induced by portal hypertension, which is commonly a consequence of cirrhosis. Other causes include thrombosis of intra-abdominal vessels, complications of pancreatitis, and intra-abdominal tumors.
Diagnosis and classification
Image:Antral varices.jpg
Diagnosis of gastric varices is often made at the time of upper endoscopy.
The Sarin classification of gastric varices identifies four different anatomical types of gastric varices, which differ in terms of treatment modalities.
Treatment
Initial treatment of bleeding from gastric varices focuses on resuscitation, much as with esophageal varices. This includes administration of fluids, blood products, and antibiotics.
The mainstay of acute treatment of bleeding from gastric varices is endoscopic injection of cyanoacrylate, known as gastric variceal obliteration or GVO. Cyanoacrylate, a common component in super glueis often mixed 1:1 with lipiodolto prevent polymerization in the endoscopy delivery optics, and to show on radiographic imaging. GVO is usually performed is specialized therapeutic endoscopy centers. Complications include sepsis, embolization of glue, and obstruction from polymerization in the lumen of the stomach.
Other techniques for refractory bleeding include:
- Transjugular intrahepatic portosystemic shunts(TIPS)
- Gastric variceal ligation, although this modality is falling out of favour
- Intra-gastric balloon tamponadeas a bridge to further therapy
- a caveat is that a larger balloon is required to occupy the fundusof the stomach where gastric varices commonly occur
- Liver transplantation
| Health science- Medicine- Gastroenterology
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| Diseases of the esophagus- stomach
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| Halitosis- Nausea- Vomiting- GERD- Achalasia- Esophageal cancer- Esophageal varices- Peptic ulcer- Abdominal pain- Stomach cancer- Functional dyspepsia
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| Diseases of the liver- pancreas- gallbladder- biliary tree
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| Hepatitis- Cirrhosis- NASH- PBC- PSC- Budd-Chiari syndrome- Hepatocellular carcinoma- Acute pancreatitis- Chronic pancreatitis- Pancreatic cancer- Gallstones- Cholecystitis
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| Diseases of the small intestine
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| Peptic ulcer- Intussusception- Malabsorption(e.g. celiac disease, lactose intolerance, fructose malabsorption, Whipple's disease) - Lymphoma
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| Diseases of the colon
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| Diarrhea- Appendicitis- Diverticulitis- Diverticulosis- IBD(Crohn's diseaseand Ulcerative colitis) - Irritable bowel syndrome- Constipation- Colorectal cancer- Hirschsprung's disease- Pseudomembranous colitis
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Categories: Medical sign stubs| Gastroenterology
This article is licensed under the GNU Free Documentation License.
It uses material from the http://en.wikipedia.org/wiki/Gastric+varices Wikipedia article Gastric varices.
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