Esophageal Varices-II: Clinical Features and Management

Esophageal varices lead to gastrointestinal bleeding, manifesting with symptoms like hematemesis, hematochezia, and melena. Additional signs include abdominal pain, jaundice, pruritus, and peripheral edema.

Assessment involves collecting a detailed medical history and performing a physical examination to detect ascites, a small, firm liver, and visible periumbilical collateral circulation.

Diagnostic imaging includes upper endoscopy to visualize and grade varices and CT scans to assess liver and portal vein abnormalities.

Medical management involves beta-blockers and vasoconstrictors to reduce portal pressure and bleeding.

Furthermore, endoscopic band ligation stops bleeding by placing rubber bands around the varices. Sclerotherapy involves injecting substances into the varices to promote scarring and closure.

Other treatments include a balloon tamponade, a transjugular intrahepatic portosystemic shunt, and surgical bypass.

Nursing care includes administering blood transfusions for anemia, fluid resuscitation for hemodynamic stability, and proton pump inhibitors to reduce gastric acid production.