Esophageal varices. 1. ESOPHAGEAL VARICES Esophageal varices are abnormal, enlarged veins in the tube that connects the throat and stomach (esophagus). This condition occurs most often in people with serious liver diseases. Esophageal varices develop when normal blood flow to the liver is blocked by a clot or scar tissue in the liver . OESOPHAGEAL VARICES AND ITS MANAGEMENT -BY SHWETA SHARMA M.SC. NURSING I YEAR AIIMS,JODHPUR 2. DEFINITION Oesophageal varices are dilated and tortuous veins in the oesophageal wall, secondary to increased venous pressure in the splanchnic venous bed or in the superior vena cava
14. ESOPHAGEAL VARICES. Esophageal varices are dilated blood vessels in the wall of the esophagus; they are often described as hemorrhoids of the esophagus. Varices are caused by liver disease and can lead to serious complications, including death. Portal hypertension is the primary cause of esophageal varices . • 3 ports: gastric balloon, gastric suction port, & esophageal balloon. • Minnesota tube has 4 ports - adds esophageal suction port. • Temporary solution to stop bleeding - should only stay in for about 24 hours. Gastric balloon - 400-500 ml of air Esophageal balloon - 30-45 mmH
View Esophageal_Varices-Case_Study-_student.ppt from NURSING FUNDAMENTA at Western Governors University. CASE STUDY Esophageal Varices • 45 y/o male, alcoholic with 2 years sobriety: Attend Esophageal varices occurs from dilated veins at the junction between the portal and systemic venous systems. Varices tend to be in the distal oesophagus and/or the proximal stomach, but isolated varices may be found in the distal stomach, large and small intestine. The majority of patients with variceal bleeding have chronic liver disease The TIPS procedure is used for the treatment of varices by upper endoscopy with banding to relieve portal hypertension. Nursing Management. Nursing management for the patient with cirrhosis of the liver should focus on promoting rest, improving nutritional status, providing skin care, reducing risk of injury, and monitoring and managing. Esophageal variceal hemorrhage is an important complication of portal hypertension and represents a significant challenge to both the gastroenterologist and gastroenterology nurse and associate (GNA). No single modality has emerged as superior for all patients, and new medications and techniques hav
Now, there are quite a few nursing concepts that apply to a patient with Cirrhosis, but our top priorities are going to be GI/Liver metabolism, knowing that we need to support liver function, clotting because of the high risk of bleeding and esophageal varices, and fluid & electrolytes because they tend to have a lot of issues with fluid overload View and Download PowerPoint Presentations on Oesophageal Varices PPT. Find PowerPoint Presentations and Slides using the power of XPowerPoint.com, find free presentations research about Oesophageal Varices PPT. About 8 results (1.65 seconds) Esophageal Perforation PPT Esophageal Varices All patients with cirrhosis should have EGD screening for varices. No varices- rescope in couple years. Small varices- consider NSBB in these patients Large varices- low risk group probably use NSBB. High risk group (red wale signs, advanced liver disease) can choose between NSBB and EVL
Esophageal varices occur most often in people with serious liver diseases. Esophageal varices develop when normal blood flow to the liver is obstructed by scar tissue in the liver or a clot. Seeking a way around the blockages, blood flows into smaller blood vessels that are not designed to carry large volumes of blood If your esophageal cancer has narrowed your esophagus, a surgeon may use an endoscope and special tools to place a metal tube (stent) to hold the esophagus open. a bluish skin color ( cyanosis) caused by low blood oxygen levels. Esophageal dysphagia—characterized by difficulty in passing food down the esophagus—is common in patients with a motility disorder, sphincter abnormal ity, or.
Esophageal Pathophysiology. Description: Esophageal Pathophysiology G caused stenosis Diverticula Diverticule Zenker s diverticulum Webs and Rings Esophageal web Slide 24 Plummer-Vinson Syndrome Slide - PowerPoint PPT presentation. Number of Views: 1435 Emergency—Bleeding Esophageal Varices: What Nurses Need to Know. By Sylvia Foley, AJN senior editor. esophageal varices. This month's CE feature opens with a patient with alcoholic cirrhosis who suddenly vomits large amounts of blood. She's experiencing variceal hemorrhage from esophageal varices, an often deadly complication of alcoholic.
setting. The nurse and associate function within the limitations of licensure, state nurse practice act, and/or institutional policy. Endoscopic Variceal Ligation (EVL)/Banding [Use in conjunction with EGD] Procedure Guide Description Under direct visualization through an endoscope, elastic bands are applied to Esophageal or Gastric Varices bleeding esophageal varices. For the purposes of this study, the science concepts identified were restricted to the physical, biological, and med-ical sciences. The study was limited to the use of the Blakemore-Sengstaken tube as the method of controlling hemorrhage from bleeding esophageal varices. Importance of the Proble To speak with a nurse, call: 800-395-6431 What is the liver? The liver is the body's largest internal organ. It is an essential organ and the Preventing bleeding from Esophageal Varices Backup of blood from the scarred liver may cause the veins in the wall of the esophagus to enlarge. The esophagus is the swallowing tube that connects th
GASTROINTESTINAL BLEEDING Hematemesis Melena Hematochezia Occult bleeding CLINICAL PRESENTATION Clinical manifestations of GI bleeding depends upon extent & rate Postural hypotension suggests acute hemorrhage & intravascular volume depletion Fatigue & exertional dyspnea typical symptoms with slow, chronic blood loss ETIOLOGY OF UGI BLEEDING Differential diagnosis is extensive Major causes; PUD. Esophageal varices are abnormal, enlarged veins in the tube that connects the throat and stomach (esophagus). This condition occurs most often in people with serious liver diseases. Esophageal varices develop when normal blood flow to the liver is blocked by a clot or scar tissue in the liver. To go around the blockages, blood flows into.
11/26/2018 6 Varices •Types of Varices •Esophageal •Gastric •Anorectal Portal System Nursing Care for Patients with Varices •Assessment •Black tarry stools, coffee ground, frank & obvious bleeding •N/V •Orthostatic hypotension •Tachycardia •Cough •Anemia •Labs •PTT, PT, INR, fibrinogen, hematocrit, hemoglobin, platelets •Acceptable abnormal labs in ESL esophageal varices. The Minnesota tube has four-lumen . Two drainage lumen: • A gastric aspiration lumen that allows drainage from below the gastric balloon and can also be used for medication administration. • An esophageal aspiration lumen that provides for drainage above the esophageal balloon. Two balloon lumen • Gastric balloo About one third of patients with cirrhosis and esophageal varices will have a significant bleed at some point. The mortality rate for a first time variceal bleed is 30-50%. A second bleed is likely to occur in about 60-70% of the survivors within the first year. One study stated the frequency of a re-blee Esophageal varices are the most common type of gastrointestinal varices, and their prevalence in Child-Pugh class A is 42.7%, around 70.7% in class B, and 75.5% in class C. The bleeding risk for small varices and large varices is around 5% and 15% per year respectively NCP Upper Gastrointestinal / Esophageal Bleeding. Bleeding duodenal ulcer is the most frequent cause of massive upper gastrointestinal (GI) hemorrhage, but bleeding may also occur because of gastric ulcers, gastritis, and esophageal varices. Severe vomiting can precipitate gastric bleeding as a result of a tear in the mucosa at the.
Transesophageal echocardiography (TEE) is a minimally invasive diagnostic study that can be done quickly and easily in most patients. Unlike transthoracic echocardiography (TTE), the more common echocardiographic study, TEE provides a clear view of virtually all cardiac structures unobstructed by bones, lungs, or the pericardial chest wall (1988) Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. A prospective multicenter study. The North Italian Endoscopic Club for the Study and Treatment of Esophageal Varices. N Engl J Med 319: 983 - 989 A client with esophageal varices has severe hematemesis and the physican is going to insert a Sengstaken-Blakemore tube. The nurse is aware that the tube is a: 1. Single-lumen tube designed for gastric lavage. 2. Double-lumen tube used for sclerotherapy and ligation of GI varices. 3. Triple-lumen tube used to compress the upper stomach and.
Abstract. Varices are caused by abnormal or circulatory disturbances of the portal vein, splenic vein, or superior vena cava. These abnormal dilatations of the submucosal veins of the esophagus and stomach may rupture and threaten the patient's life. Treatment of this condition is aimed mainly at the prevention and control of its most serious. Bleeding esophageal varices are life-threatening, and immediate treatment is essential. Treatments used to stop bleeding and reverse the effects of blood loss include: Using elastic bands to tie off bleeding veins. Your doctor may wrap elastic bands around the esophageal varices during an endoscopy. Medications to slow blood flow into the.
The treatment of oesophageal varices using a Sengstaken-Blakemore tube: considerations for nursing practice. Teresa Christensen. • Nursing practice pertaining to the care of this patient group appears ad hoc and reliant on local knowledge and experience, as opposed to recognized evidence of best practice. Portal hypertension, development of esophageal varices; Desired Outcomes. Maintain homeostasis with absence of bleeding; Demonstrate behaviors to reduce risk of bleeding. Nursing Interventions. Closely assess for signs and symptoms of GI bleeding: check all secretions for frank or occult blood
Small esophageal varices. In patients with small esophageal varices (diameter of 5 mm or less) (see Figure 5 below) that have not bled, nonselective beta-blockers may slow down variceal growth, but have not been shown to confer a survival advantage 11).Given the potential for side effects, the use of nonselective beta-blockers for primary prophylaxis in patients with small esophageal varices. Objective: - Hematemesis - Melena - EGD findings: Esophagus varices grade 1-2 portal hypertensive gastropathy, severe Risk for bleeding related to presence of esophageal varices In portal hypertension, collateral circulation develops in the lower esophagus as venous blood, which is diverted from the GI tract and spleen because of portal. Nausea, vomiting, straining to stool, coughing, sneezing, and lifting heavy objects. Risk factors for bleeding with esophageal varices are: Variceal size, decreased wall thickness, and the degree of liver dysfunction. Patients with esophageal varices should avoid: Alcohol, aspirin, irritating foods coughing, and upper respiratory infections
Esophageal varices are the major complication of portal hypertension. It is detected in about 50% of cirrhosis patients, and approximately 5-15% of cirrhosis patients show newly formed varices or worsening of varices each year. The major therapeutic strategy of esophageal varices consists of primary prevention, treatment for bleeding varices, and secondary prevention, which are provided by. Background & Aims: Studies of octreotide have not demonstrated a consistent benefit in efficacy or safety compared with conventional therapies. This study statistically pooled existing trials to evaluate the safety and efficacy of octreotide for esophageal variceal hemorrhage. Methods: We identified randomized trials of octreotide for variceal hemorrhage from computerized databases, scientific. Esophageal varices (EV) are present in majority of the patients with hepatic cirrhosis at the time of diagnosis, especially in patients with advanced liver disease. Development and growth of varices occur at a rate of 7% per year. Variceal size, red wale marks on varices, and advanced liver disease are risk factors for variceal hemorrhage The gold standard for the diagnosis of varices is esophagogastroduodenoscopy (EGD). It is generally recommended that patients with cirrhosis undergo elective endoscopic screening for varices at the time of diagnosis and periodically thereafter if no or small varices are detected ().If screening EGD reveals appreciable esophageal varices, a size classification should be assigned Hemorrhage from esophageal varices is a lethal complication in liver cirrhosis, 1,2 and the prevalence of variceal bleeding is higher in patients with hepatocellular carcinoma (HCC) compared with those without HCC. 3 Endoscopic therapies such as endoscopic injection sclerotherapy (EIS) and variceal ligation have improved the overall management of variceal hemorrhage, 4-7 and we demonstrated.
Gastroesophageal varices are the fourth most common cause of upper gastrointestinal bleeding (UGIB) and account for almost 12% of cases ( Fig. 41-1 ). 1 In patients with cirrhosis, varices account for up to 80% of cases of UGIB. 2, 3 In patients with established gastric or esophageal varices, the annual incidence of acute hemorrhage ranges from. Esophageal varices occur when fragile, thin-walled esophageal veins become distended and tortuous from increased pressure. The potential for varices to bleed depends on their size; size is determined by direct endoscopic observation. Varices occur most often in the distal esophagus but can also be present in the stomach and rectum
Bands are placed around the large varices in your esophagus. The pressure of the bands causes the varices to shrink. Endoscopic sclerotherapy uses medicine in the varices to make them smaller and stop the bleeding. Surgery may be needed to control the bleeding. A shunt may be placed in a vein in your liver. The shunt is connected to a larger vein Bleeding esophageal varices is a life-threatening emergency. About 50% of people who have bleeding from esophageal varices will have the problem return during the first one to two years. The risk of recurrence can be reduced with treatment. Prevention. The best way to prevent esophageal varices is to reduce your risk of cirrhosis North Italian Endoscopic Club for the Study and Treatment of Esophageal Varices. Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. A prospective multicenter study. N Engl J Med 1988; 319:983. Beppu K, Inokuchi K, Koyanagi N, et al. Prediction of variceal hemorrhage by esophageal endoscopy As noted, banding is more effective than sclerotherapy for long-term management of esophageal varices, especially when used in combination with beta-blocker therapy. For patients who have portal.
life-threatening complication of liver cirrhosis is esophageal varices. About 90% of patient with liver cirrhosis develops esophageal varices. This is usually asymptomatic and is only diagnosed only during autopsy. It is a fatal complication to portal hypertension among cirrhotic patients . Venous blood from portal vein moves to the liver. Esophageal cancer is a cancerous (malignant) tumor of the esophagus, the muscular tube that moves food from the mouth to the stomach. Esophageal cancer can be of two cell type: adenocarcinoma and squamous cell carcinoma. fPATHOPHYSIOLOGY. Risk factor: Chronic ingestion of hot liquids or food , GERD, Nutritional deficiency, Barretts esophagus. Nclex 100 questions and answers with rationale (pediatric nursing) free ebook download as powerpoint presentation (.Ppt), pdf file (.Pdf), text file (.Txt) or view. Nclex pn practice exam 3 rnpedia. Nclex review about digestive problems 41. The client with liver cirrhosis has developed esophageal varices Proximal or 'downhill' esophageal varices are a rare cause of upper gastrointestinal hemorrhage. Unlike the much more common distal esophageal varices, which are most commonly a result of portal hypertension, downhill esophageal varices result from vascular obstruction of the superior vena cava (SVC). While SVC obstruction is most commonly secondary to malignant causes, our review of the. Esophageal dysphagia is caused by damage or disease of the throat. : Achalasia —food or drink doesn't move toward the stomach as it should. Damage to nervous system that affects how muscles in the throat work. Narrowing of the throat— esophageal stricture. Esophageal cancer. Inflammation—esophagitis
Available to all NHS Staff. Access Guidelines, Latest Medical Updates and More. Symptoms, Diagnosis and Management Information from BMJ Best Practice Esophageal varices are enlarged veins that occur in the walls of the esophagus. The esophagus is the tube that connects your throat to your stomach. The pressure in the swollen veins is higher than normal. The increased pressure can cause sudden and severe bleeding. Because of this risk of bleeding, esophageal varices are a serious, possibly. World's Best PowerPoint Templates - CrystalGraphics offers more PowerPoint templates than anyone else in the world, with over 4 million to choose from. Winner of the Standing Ovation Award for Best PowerPoint Templates from Presentations Magazine. They'll give your presentations a professional, memorable appearance - the kind of sophisticated look that today's audiences expect The nurse should approach the patient in a punitive manner, use short phrases for communication, and use the threat of restraints to persuade the patient to regress fro potential violence. A 50 y/o with esophageal varices on Pitressin. A head trauma pt. with a skull fracture. PowerPoint Presentation Last modified by Keywords: quality of nursing care , patient, satisfaction , factors, esophageal varices. 1. INTRODUCTION Esophageal varices (EV) is a potentially life-threatening complication of cirrhosis[1,2,3]. Liver cirrhosis is the thirteenth leading cause of death worldwide [3,4,5]. In Egypt, the esophageal varices is the main leading cause of uppe