Gastrointestinal varices history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
History
Patients suffering from gastrointestinal varices may present with other co-morbid conditions which lead to portal hypertension. Patients may have the following history findings:
Family history
Patients with a family history of the following may be more prone to develop varices:
- Venous abnormalities
- Hypercoaguable states
- Autosomal recessive polycystic kidney disease (may lead to hepatic fibrosis)
- Nephronophthisis 1
- Joubert syndrome and related disorders 5
- Bardet-Biedl syndrome 7
- Meckel syndrome 9
- Cranioectodermal dysplasia
- Ellis-van Creveld syndrome
- Jeune asphyxiating thoracic dystrophy
- Renal-hepatic-pancreatic dysplasia
- Autosomal dominant polycystic kidney disease
Past medical
Patients with following findings on past medical history may have a higher chance of developing gastrointestinal varices:
- Chronic liver disease (cirrhosis)
- Portal vein thrombosis (Budd-Chiari syndrome)
- Splanchnic arteriovenous fistula
- Gaucher's disease
- Lymphoma
- Schistosomiasis
- Adult polycystic liver disease
- Hepatic arteriopetal fistula
- Congenital hepatic fibrosis
- Idiopathic noncirrhotic portal hypertension (including nodular regenerative hyperplasia)
- Zellweger syndrome
- Mastocytosis
Social history
Patients may have the following social history findings:
- Chronic alcohol intake
- Poor adherence to medications
- Smokers are more prone to develop bleeding of varices
Symptoms
Non-bleeding gastrointestinal varices do not produce any symptoms, however bleeding gastrointestinal varices may lead to the following symtoms:
Common symptoms
Common symptoms of bleeding gastrintestinal varices include the following:[1][2][3][4][5][6]
- Hematemesis
- Abdominal pain
- Lightheadedness
- Loss of consciousness
- Melena
- Bloody stools (in severe cases)
- Shock (in case of loss of a large volume of blood)
References
- ↑ Cremers I, Ribeiro S (2014). "Management of variceal and nonvariceal upper gastrointestinal bleeding in patients with cirrhosis". Therap Adv Gastroenterol. 7 (5): 206–16. doi:10.1177/1756283X14538688. PMC 4107701. PMID 25177367.
- ↑ Fawaz KA, Kellum JM, Deterling RA (1982). "Intraabdominal variceal bleeding". Am. J. Gastroenterol. 77 (8): 578–9. PMID 7102642.
- ↑ Sato H, Kamibayashi S, Tatsumura T, Yamamoto K (1987). "Intraabdominal bleeding attributed to ruptured periumbilical varices. A case report and a review of the literature". Jpn J Surg. 17 (1): 33–6. PMID 3494875.
- ↑ Kim YD (2014). "Management of acute variceal bleeding". Clin Endosc. 47 (4): 308–14. doi:10.5946/ce.2014.47.4.308. PMC 4130884. PMID 25133116.
- ↑ Perri GA, Khosravani H (2016). "Complications of end-stage liver disease". Can Fam Physician. 62 (1): 44–50. PMC 4721840. PMID 26796834.
- ↑ Biecker E, Heller J, Schmitz V, Lammert F, Sauerbruch T (2008). "Diagnosis and management of upper gastrointestinal bleeding". Dtsch Arztebl Int. 105 (5): 85–94. doi:10.3238/arztebl.2008.0085. PMC 2701242. PMID 19633792.