5-Minute Emergency Consult
Varices
Varices is a topic covered in the 5-Minute Emergency Consult.
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Basics
Description
Description
- Increased portal venous pressure results in portal–systemic shunts
- Shunts at gastroesophageal junction result in fragile submucosal esophageal varices
Etiology
Etiology
- 10–30% of all cases of upper GI bleeding
- 90% of upper GI bleeding in patients with cirrhosis
- Variceal hemorrhage occurs in 30% of patients with cirrhosis:
- 50% will stop bleeding spontaneously
- 30% mortality per episode
- 70% have recurrent bleeding
- In adults:
- Cirrhosis due to alcoholism or chronic hepatitis
- Storage disease: Wilson or hemochromatosis
- Middle East: Schistosomiasis
- Portal HTN
- In children:
- Intrahepatic obstruction from biliary cirrhosis
- Biliary atresia
- Cystic fibrosis
- Hepatitis
- Portal HTN
- Congenital hepatic fibrosis
- History of liver transplant
- Umbilical vein cannulation
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Basics
Description
Description
- Increased portal venous pressure results in portal–systemic shunts
- Shunts at gastroesophageal junction result in fragile submucosal esophageal varices
Etiology
Etiology
- 10–30% of all cases of upper GI bleeding
- 90% of upper GI bleeding in patients with cirrhosis
- Variceal hemorrhage occurs in 30% of patients with cirrhosis:
- 50% will stop bleeding spontaneously
- 30% mortality per episode
- 70% have recurrent bleeding
- In adults:
- Cirrhosis due to alcoholism or chronic hepatitis
- Storage disease: Wilson or hemochromatosis
- Middle East: Schistosomiasis
- Portal HTN
- In children:
- Intrahepatic obstruction from biliary cirrhosis
- Biliary atresia
- Cystic fibrosis
- Hepatitis
- Portal HTN
- Congenital hepatic fibrosis
- History of liver transplant
- Umbilical vein cannulation
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Citation
Schaider, Jeffrey J., et al., editors. "Varices." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307322/all/Varices.
Varices. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307322/all/Varices. Accessed March 21, 2023.
Varices. (2016). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (5th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307322/all/Varices
Varices [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2023 March 21]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307322/all/Varices.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Varices
ID - 307322
ED - Barkin,Adam Z,
ED - Shayne,Philip,
ED - Rosen,Peter,
ED - Schaider,Jeffrey J,
ED - Barkin,Roger M,
ED - Hayden,Stephen R,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307322/all/Varices
PB - Lippincott Williams & Wilkins
ET - 5
DB - Emergency Central
DP - Unbound Medicine
ER -
