Gastrointestinal varices risk factors: Difference between revisions
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==Overview== | ==Overview== | ||
The most potent [[risk factor]] for the development of gastrointestinal varices is increased [[Portal venous system|portal venous]] pressure. Conditions that predispose an individual to development of increased [[Portal venous system|portal venous]] pressure and consequently leading to varices can be divided into three. Those leading to development of varices, those involved in progression of varices from small to large size and those leading to variceal [[hemorrhage]]. | |||
==Risk Factors== | ==Risk Factors== | ||
The following are the common risk factors that lead to gastrointestinal varices: | The following are the common risk factors that lead to gastrointestinal varices:<ref name="pmid17140886">{{cite journal |vauthors=Sanyal AJ, Fontana RJ, Di Bisceglie AM, Everhart JE, Doherty MC, Everson GT, Donovan JA, Malet PF, Mehta S, Sheikh MY, Reid AE, Ghany MG, Gretch DR, Halt-C Trial Group |title=The prevalence and risk factors associated with esophageal varices in subjects with hepatitis C and advanced fibrosis |journal=Gastrointest. Endosc. |volume=64 |issue=6 |pages=855–64 |year=2006 |pmid=17140886 |doi=10.1016/j.gie.2006.03.007 |url=}}</ref> | ||
High portal | |||
Large varices | === Development of varices === | ||
Red marks on the varices | * High hepatic venous portal gradient (HPVG > 10 mm Hg) | ||
Severe cirrhosis or liver failure | |||
Continued alcohol use | === Progression from small to large varices === | ||
* Decompensated varices | |||
* [[Alcoholic cirrhosis]] | |||
* Red sign of [[endoscopy]] (dilated [[Blood vessel|vessels]] on the surface of varices) | |||
=== Variceal hemorrhage === | |||
* Large varices ( > 5 mm) | |||
* Red sign | |||
* High [[MELD Score|MELD score]] | |||
* HVPG > 16 mmHg | |||
* [[Coagulopathy]] | |||
* [[Thrombocytopenia]] | |||
* Increasing [[bilirubin]] | |||
* [[INR|Increased international normalized ratio]] ([[INR]]) | |||
* Red marks on the varices | |||
* Severe [[cirrhosis]] or [[liver failure]] | |||
* Continued [[alcohol]] use | |||
==References== | |||
{{reflist|2}} | |||
{{WH}} | |||
{{WS}} | |||
Latest revision as of 13:26, 26 January 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
The most potent risk factor for the development of gastrointestinal varices is increased portal venous pressure. Conditions that predispose an individual to development of increased portal venous pressure and consequently leading to varices can be divided into three. Those leading to development of varices, those involved in progression of varices from small to large size and those leading to variceal hemorrhage.
Risk Factors
The following are the common risk factors that lead to gastrointestinal varices:[1]
Development of varices
- High hepatic venous portal gradient (HPVG > 10 mm Hg)
Progression from small to large varices
- Decompensated varices
- Alcoholic cirrhosis
- Red sign of endoscopy (dilated vessels on the surface of varices)
Variceal hemorrhage
- Large varices ( > 5 mm)
- Red sign
- High MELD score
- HVPG > 16 mmHg
- Coagulopathy
- Thrombocytopenia
- Increasing bilirubin
- Increased international normalized ratio (INR)
- Red marks on the varices
- Severe cirrhosis or liver failure
- Continued alcohol use
References
- ↑ Sanyal AJ, Fontana RJ, Di Bisceglie AM, Everhart JE, Doherty MC, Everson GT, Donovan JA, Malet PF, Mehta S, Sheikh MY, Reid AE, Ghany MG, Gretch DR, Halt-C Trial G (2006). "The prevalence and risk factors associated with esophageal varices in subjects with hepatitis C and advanced fibrosis". Gastrointest. Endosc. 64 (6): 855–64. doi:10.1016/j.gie.2006.03.007. PMID 17140886. Vancouver style error: initials (help)