CIRRHOSIS OF LIVER

Cirrhosis of liver related to alcoholism with complications of esophegeal varicies



Cirrhosis of liver related to alcoholism with complications of esophegeal varicies

Introduction

Esophageal varices in cirrhosis of liver come from the higher pressure in the portal vein and the development of collaterals portosystem vein. Bleeding from esophageal varices is an urgent clinical condition followed by a high mortality rate. In this regard, prevention of first bleeding is very important. For this purpose, non-selective beta blockers have been better, because they can be combined with long-effects of nitrates, as well as programmed endoscopic intervention. After the treatment of acute bleeding esophageal varices, we continue with the preventive treatment to reduce the pressure in the flow of the portal vein and prevent recurrent bleeding. In addition, beta-blockers, long-term effect of nitrates used and programmed endoscopic sclerosis and liging varices.

Liging has an advantage and it will be adopted as a method of choice. One possibility to prevent a recurrence of bleeding from esophageal varices programmed positioning transjugular intrahepathitic shunt portosystem (TIPS) and is available for patients with cirrhosis who are candidates for liver transplantation. Surgery "shunt" is offered to patients with well preserved liver function, and they are not candidates for councils. New opportunities for prevention and treatment of esophageal varices is now intensively studied. Bleeding from esophageal varices matters worse, prevention of bleeding improves the prognosis of patients with cirrhosis and portal hypertension.

Discussion

Portal vein system of transfers in 1500 ml of blood to the liver from the spleen, stomach, small intestine and colon. Obstruction of the flow in this vein, the different results in an increase in the etiology of venous portal pressure. In response to increased pressure veins, vein collateral circulation developed a system of veins to bypass the obstacles bloodstream. Those liens portosystem connect the portal vein with the upper and lower hollow vein. High portal pressure is the main cause of portosystem liens, but there are other factors that may also be included, such as active angiogenesis. The most important portosystem anstomose are gastrointestinal liens. According to the blood drainage vein azigos, these deposits form esophageal varices responsible for the most frequent complications of portal hypertension - the massive hemorrhage of upper digestive tract. The most common cause (about 90% of all cases), portal hypertension is cirrhosis. Cirrhosis is a global problem. It can be found in all social classes, races, ages and both sexes, although male mortality from this disease is two times higher than mortality among women.

The most frequent causes of cirrhosis are alcohol abuse and viral hepatitis. Data on the prevalence and incidence are unknown, because the disease is often asymptomatic, but sometimes found in the autopsy. Based on the results of an autopsy, the prevalence of cirrhosis is 4-10% and the incidence of 240 patients per million population per year. About 20% of patients with cirrhosis have a high varices which poses a real threat to the bleeding. The first bleeding ends mortality by about 30% of ...