Varicose veins in the oesophagus.
Dilated veins found within the lower esophageal walls and occasionally in the upper section of the stomach.
Oesophageal varices emerge as a result of portal hypertension, which involves elevated blood pressure in the portal vein, often attributed to liver disease. As blood flows from the intestines to the liver via the portal vein, liver disease creates resistance, redirecting the blood into small veins within the esophageal and stomach walls. This heightened blood pressure leads to the expansion of these veins, causing them to bulge outward.
Usually, symptoms are absent until a bleeding episode occurs, leading to recurrent instances of hematemesis (vomiting blood) and the discharge of dark stools. Additional indications of chronic liver disease are typically present.
In order to manage acute bleeding, swift action involves endoscopic application of a sclerosant to close off the affected veins. Alternatively, banding may be employed, wherein tight rubber bands are positioned at the base of each enlarged vein. Additionally, strategies encompass replenishing lost blood and administering intravenous drugs like octreotide and terlipressin to narrow blood vessels. There is also the option of creating a shunt, a surgically established passage, to redirect blood away from the varices. However, even with treatment, a bleeding episode might still carry the risk of fatality.