Varices

Varices are abnormal, dilated vessels due to a prolonged increase in pressure, typically in the veins. They are most commonly observed in the esophagus (esophageal varices) and the stomach (gastric varices), but can also occur in other areas of the body.

Causes

Varices are caused by high blood pressure in the portal vein (portal hypertension), which is the large vein that brings blood to the liver from the intestines, spleen, pancreas, and gallbladder. The most common cause of portal hypertension is cirrhosis of the liver, a disease in which the liver cells are damaged and replaced by scar tissue. Other causes include blood clots in the portal vein (portal vein thrombosis) and a parasitic infection called schistosomiasis.

Symptoms

Varices themselves do not cause symptoms. However, if they rupture and bleed, they can cause serious complications. Symptoms of bleeding varices include vomiting of blood, black, tarry or bloody stools, lightheadedness, and loss of consciousness.

Diagnosis

Varices are usually discovered when a doctor performs an endoscopy to investigate the cause of upper gastrointestinal bleeding. During an endoscopy, a flexible tube with a light and a camera on the end is inserted through the mouth and into the esophagus and stomach. Other tests that can help diagnose varices include a CT scan, MRI, and ultrasound of the abdomen.

Treatment

The goal of treatment is to prevent bleeding. Medications such as beta blockers or nitrates are often used to reduce the pressure in the portal vein. If bleeding occurs, treatments may include banding (a procedure in which a doctor uses a special device to place a band around the varices), sclerotherapy (injection of a solution into the varices to cause them to scar and stop bleeding), or a transjugular intrahepatic portosystemic shunt (TIPS), a procedure that creates a new pathway for blood flow in the liver.

See also

• Portal hypertension
• Cirrhosis
• Esophageal varices
• Gastric varices

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