What is the most serious complication of esophageal varices?
The most serious complication of esophageal varices is bleeding. Once you’ve had a bleeding episode, your risk of another bleeding episode greatly increases. If you lose enough blood, you can go into shock, which can lead to death.
How does splenic vein thrombosis cause gastric varices?
Blockage of the splenic vein leads to sinistral portal hypertension and the development of collateral vessels to circumvent the thrombus. Gastric varices form when pressure builds up within the submucosal veins of the fundus.
How does splenic vein thrombosis cause portal hypertension?
Splenic vein occlusion results in back pressure which is transmitted through its anastomoses with the short gastric and gastroepiploic veins and subsequently via the coronary vein into the portal system. This results in reversal of flow in these veins and the formation of gastric varices.
What is splenic vein thrombosis?
Splenic vein thrombosis (plural: thromboses) is an uncommon condition in which the splenic vein becomes thrombosed, that most frequently occurs in the context of pancreatitis or pancreatic cancer.
How serious is splenic vein thrombosis?
Depending on the site of thrombosis, patients are at risk of developing liver insufficiency, portal hypertension, or bowel infarction and may experience recurrence in both the splanchnic veins and other vein segments.
How are the varices of the stomach classified?
This endoscopic examination is also useful in understanding the orientation of varices in the stomach and distal esophagus. According to Sarin classification, the gastric varices are divided into four types based on their location in the stomach and its association with the esophageal varices.
How are gastric varices related to segmental portal hypertension?
On the other hand, the isolated gastric varices (IGV1) are related to the segmental portal hypertension or with the collaterals through the vein in the spleen that extends till renal vein. This process is mainly because to enable blood flow through the varices.
Which is better gov1 or sclerotherapy for fundal varices?
GOV1 is similar to that of EV, and endoscopic band ligation (EBL) is preferred to sclerotherapy because of a lower risk of complications. However, EBL and sclerotherapy may be ineffective therapies for fundal varices (GOV2 and IGV1) because of high rebleeding rates and the potential for mas- sive bleeding from large treatment-induced ulcers.
How are gastro esophageal varices related to cirrhosis?
Gastro-esophageal varices (GEV) and variceal hemorrhage (VH) are clinical milestones in the natural history of cirrhosis, as they are closely related to the severity of portal hypertension and define specific stages in disease progression.