OESOPHAGEAL VARICES

Extremely dilated sub-mucosal veins in the lower third of the esophagus, due to portal hypertension caused by liver
cirrhosis. They can cause severe upper gastrointestinal bleeding.

Management

  • Screen patients with liver cirrhosis with endoscopy to assess for presence of varices
  • In case of varices, consider the use of beta blockers to prevent bleeding
    • Propranolol 20 mg every 12 hours, titrate to keep resting heart rate at 55-60 bpm
    • Avoid in refractery ascitis and SBP
  • Endoscopic ligation sclerotherapy
  • If acute bleeding.