Varicose veins of the esophagus is due to violations of the outflow of blood from the veins of the esophagus through the ducts of the portal and superior vena cava. The average age of patients with esophageal varices — 50 years, and men are affected twice as often as women.
The reason for this is the most frequent disorders portal hypertension, i.e. increasing the pressure in the portal vein pool. The reasons can be a disease of the liver (cirrhosis, chronic hepatitis, cancer, tuberculosis, hydatid disease, etc.), thrombosis or compression of the portal vein (tumors, cysts, adhesions, bile duct stones, etc.). Less commonly, varicose expansion veins of the esophagus is due to increase of pressure in the systemic circulation, such as chronic cardiovascular disease. If it is difficult outflow of blood veins dilate the esophagus, twists and elongated, forming varices, the walls of these blood vessels become thinner and can rupture, causing bleeding.
Disease for many years may be asymptomatic or manifest chest tightness, belching, moderate ingestion of food disorders, heartburn, i.e. symptoms usually associated varices esophagitis (inflammation of the esophagus).
The most serious complication of varicose veins is bleeding. It can occur after eating, exertion, but it can happen in a dream. Bleeding may be small, almost imperceptible to the human, or a massive, life-threatening. But even small in size, but regular blood loss due to illness can cause the development of chronic iron deficiency anemia. A characteristic feature of esophageal bleeding is vomiting bright red blood.
Diagnosis of the disease is carried out on the basis of laboratory data, liver ultrasound, to identify the source of bleeding perform esophagoscopy and X-ray examination.
Treatment is primarily directed to treatment diseases causing increased pressure in the portal vein and vena. It is also important prevention or treatment of an existing occurrence of reflux esophagitis. For minor or moderate bleeding effective treatments are the introduction of vasopressors, vascular compression of the esophagus plugging bottles or using a probe for the local cryotherapy on the damaged vessel. Also, endoscopic surgery, during which the electrocoagulation, applying adhesive tape or thrombin hemostatic clamping straps bleeding vessel. However, massive bleeding is necessary to satisfy the more radical surgery. To compensate for the loss of whole blood is transfused patients blood, red cell mass and plasma-substituting solutions.