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Esophageal Variceal Bleeding

Esophageal variceal bleeding due to portal hypertension is a high-mortality emergency.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Esophageal Variceal Bleeding?

Esophageal varices are dilated veins that develop in the esophagus due to portal hypertension caused by liver cirrhosis. Bleeding is a life-threatening complication.

The clinical picture includes sudden, massive hematemesis, melena, weakness, and shock. Mortality at first episode is around 15-20%.

Treatment includes hemodynamic stabilization, vasoactive drugs (octreotide, terlipressin), antibiotic prophylaxis, and emergency upper GI endoscopy with band ligation.

Symptoms

Sudden massive hematemesis
Dark melena
Weakness, tachycardia, hypotension
Jaundice, ascites, signs of liver disease
Symptoms of hepatic encephalopathy
Pale, cold skin

Risk Factors

Liver cirrhosis (alcohol, viral hepatitis, NAFLD)
History of previous variceal bleeding
Large varices (F2-F3) and red wale signs
Portal vein thrombosis
Child-Pugh class C patients
Non-compliant patients

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Call 112 immediately if a known cirrhotic patient has hematemesis or melena
  • Sudden fainting and cold sweating are signs of severe bleeding
  • Reaching upper GI endoscopy without delay is important
  • Antibiotic prophylaxis should be given within the first 24 hours

Treatment Methods

01
Aggressive hemodynamic stabilization
02
Transfusion of blood and blood products
03
IV octreotide or terlipressin
04
Prophylactic antibiotics (ceftriaxone)
05
Emergency endoscopic band ligation
06
TIPS or balloon tamponade (Sengstaken tube) in refractory cases

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.