Varicose veins of the esophagus
Varicose veins of the esophagus - Change in the form of non-uniform increase in lumen and wall protrusion in conjunction with uzlovatopodobnoy tortuosity of vessels.
This disease can be congenital or develop due to increased pressure in the portal vein (portal hypertension). The acquired form occurs much more frequently.
Some causes of varicose veins of the esophagus:
changes affecting the parenchyma of the liver (cirrhosis, cancer, amyloidosis, echinococcosis)
narrowing of the diameter of portal vein thrombosis in her, sclerosis or compression from the outside,
endoflebit hepatic veins (Chiari's disease),
hypertension not only in the portal system, but also in the systemic circulation as a whole (for chronic cardiovascular disease).
increase in abdominal volume due to the presence of large amounts of free fluid in the abdomen (ascites)
extension of superficial vein on the anterior abdominal wall, especially around the navel ("Medusa head").
With slow development of the disease the patient may for a long time unaware of the existing pathology until such time as it becomes a random finding or may not have any complications.
With progressive varicose veins, within a few days before the bleeding begins to disturb often a feeling of heaviness and constriction in the chest.
Diagnosis is based on fibroezofagoskopii held. Fibroezofagoskopiya pozvolyayuet determine the degree of dilation of the veins, to assess the state of the vascular wall, to reveal the erosive and ulcerative lesions of the esophageal mucosa. Also apply rentgenkontrastnoe study.
The most serious complication of esophageal variceal bleeding is often arise suddenly and require emergency care.
The main treatment aims to reduce the pressure in the portal system (with medical therapy or bypass surgery), and obliteration of varices. It is also necessary to stabilize or, if possible, eliminate the underlying disease.
For the prevention and treatment of peptic esophagitis used binders and antacids to prevent the transition of inflammation in the walls of ectatic veins of the esophagus that can cause bleeding.
Where indicated, conduct, and surgical treatment.
Patients were assigned to light diet, consisting in the use of negoryachey liquid, mushy, crushed food, and we recommend limiting physical activity.
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