7.20.2012

PANCE REVIEW: Varices

Let's head north of the heart for a while - I'm CV-system'd out for a bit. The esophagus. The must-know topics about the esophagus are below. I won't get to all of them on my blog... but you should def get to them in your studies!

Esophagitis
Motility d/o's
Mallory-Weiss tears
Neoplasms
Strictures
Varices

Let's chat about Varices today...

Def:
Dilations of veins (generally found distally)

Causes:
-Usual underlying cause is portal HTN which is usually secondary to cirrhosis
-Chronic viral HEP and NSAIDS can worsen bleeding
-*Budd-Chiari Syndrome may cause thrombosis of portal vein which can lead to varices

Dx:
-Usually diagnosed clinically
-Asymptomatic until they start to bleed - then they are LIFE THREATENING!

Tx:
-Hemodynamic support
-High vol IVF
-Vassopressors
-Endoscopic therapy+Pharm vasoconstriction

**30% of pts die during the 1st bleed, 50% of those that survive will die during the 2nd bleed**



Picture: http://www.bio.ri.ccf.org/Henderson/port.html
Source: AAPA/PAEA Exam Review Book

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