Pathology - Esophageal Variceal Hemorrhage
Pathophysiology The patient can exhibit blood in their vomit as a result of severe bleeding from esophageal varices. Patients with liver cirrhosis-related portal hypertension frequently have this consequence. An increase in both portal blood flow and intrahepatic vascular resistance occurs simultaneously, leading to portal hypertension. As portal venous pressure rises, the lower esophageal veins, which are the location of portal systemic anastomosis, widen. Because there are circulating vasodilator chemicals in advanced liver disease, there is a decrease in systemic vascular resistance. Increases in portal blood flow, portal venous pressure, and esophageal venous pressure result from this hyperdynamic circulation. Because nonspecific betablockers reduce cardiac output and subsequently portal blood flow, they can occasionally be used as a preventative measure. This patient experienced considerable bleeding as well as varices rupturing. Plasma may be used during resuscitation to counteract coagulopathy brought on by liver illness. Somatostatin reduces bleeding immediately and is an efficient splanchnic vasoconstrictor. Additionally, an esophagogastroduodenoscopy will be done to bandage or sclerose the bleeding varices.
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