Gastric Varices: Causes, Symptoms, Treatment, Surgery
What are Gastric Varices?
Gastric Varices is a condition which arises from a pathological condition of the liver in which there is increased pressure on the portal veins. The pressure on the portal veins usually is increased due to a liver dysfunction most commonly cirrhosis of the liver. This increased pressure in the portal veins is termed as portal hypertension. If this condition is left untreated it results in what is called as Gastric Varices.
Gastric Varices occurs when the submucosal veins get dilated within the stomach. This condition is relatively asymptomatic as long as Gastric Varices do not start bleeding. Once Gastric Varices ruptures or starts bleeding then the bleeding may be severe and may cause excessive blood loss which may be potentially life-threatening. Gastric Varices may also occur as a result of splenic vein thrombosis which is a complication of acute pancreatitis, pancreatic cancer, or other abdominal tumors. Hepatitis C may also cause Gastric Varices as a potential complication.
Bleeding Gastric Varices may cause an individual to have hemoptysis, black tarry stools, or rectal bleeding. Once the bleeding gets acute it may cause extremely serious complications. Thus it is absolutely necessary in order to prevent serious complications to treat Gastric Varices.
What Causes Gastric Varices?
As stated, Portal hypertension is the primary cause of Gastric Varices. Portal hypertension arises when there is increased pressure on the portal veins as a result of some liver dysfunction such as liver cirrhosis or fatty liver.
This increased pressure in the portal veins causes the blood to be forced away from the liver to other smaller blood vessels which are not able to handle this increase of blood flow resulting in development of large and swollen veins which in medical terms is called as varices.
These varices when formed in the gastric area or the stomach are called Gastric Varices. These varices are extremely sensitive and tend to rupture with even a little bit of pressure resulting in profound internal bleeding and blood loss. Thus it is necessary for an individual to be treated immediately in case if he or she is diagnosed with Gastric Varices.
What are the Symptoms of Gastric Varices?
Gastric Varices in the initial stages is asymptomatic but an individual will experience the following symptoms if Gastric Varices starts to bleed. The symptoms include:
- Black and tarry stool
- Blood in the stools
- In severe cases shock.
Gastric Varices bleeding in a medical emergency and requires emergent treatment to stop the flow of blood and prevent any significant blood loss. In some cases, even after the blood is topped from a bleeding Gastric Varices there can be certain complications that may arise like pneumonia, sepsis, liver failure, or kidney failure as a result of a bleeding Gastric Varices.
How is Gastric Varices Treated?
In extreme cases where the patient has gone into shock because of a bleeding Gastric Varices then the patient may need to be intubated until the bleeding is stopped. This is to prevent the lungs from being filled with blood. The patient is started immediately on intravenous antibiotics to reduce the risks of complications like sepsis.
The main aim of treatment of a bleeding Gastric Varices is to stop the bleeding and also to prevent further blood loss. This is done surgically by the following procedures as mentioned below.
Surgical Treatment of Gastric Varices
This is a procedure in which the surgeon places small rubber bands directly over the varices to stop the bleeding and treat Gastric Varices
This is a procedure in which the varices are directly injected with an anticoagulant or an ani-clotting agent to prevent further bleeding and blood clot formation and treat Gastric Varices
Transjugular Intrahepatic Portosystemic Shunt
This is a procedure in which a stent is placed in the center of the liver. This stent joins the hepatic vein to the portal vein. This is basically done to relieve the excess pressure that has built up in the portal vein and treat portal hypertension and thus preventing formation of Gastric Varices.