Gastric Variceal Bleeding

Gastric variceal bleeding is a serious condition that occurs when enlarged veins in the lining of the stomach (gastric varices) rupture and bleed. These varices develop due to increased pressure in the portal vein system, a condition known as portal hypertension.

Portal hypertension is most commonly caused by cirrhosis, a chronic liver disease that damages and scars liver tissue. When the liver is damaged, blood flow through the liver becomes obstructed, leading to increased pressure in the portal vein, which carries blood from the intestines, spleen, and stomach to the liver.

While less common than esophageal variceal bleeding (bleeding from enlarged veins in the esophagus), gastric variceal bleeding can be life-threatening.

Causes

- Portal hypertension from cirrhosis (most common)
- Splenic vein thrombosis
- Other causes of portal hypertension

Symptoms

- - Vomiting blood (hematemesis)
  - Dark, tarry stools (melena)
  - Rectal bleeding
  - Shock (in severe cases)

Diagnosis

- Endoscopy (upper endoscopy)
- Imaging tests (angiography, CT scan)

Treatment

- Endoscopic therapies (injection with sclerosing agents, band ligation)
- Medication (octreotide)
- Transjugular intrahepatic portosystemic shunt (TIPS procedure)
- Surgery (in some cases)
- BRTO /PARTO can be performed to treat gastric varices (Click here to read more on Balloon occluded retrograde Transvenous obliteration(BRTO)) .

Prevention

- Management of underlying liver disease
- Endoscopic therapy for high-risk varices

Complications

- Re-bleeding
- Infection
- Hepatic encephalopathy (confusion and other brain dysfunction)
- Death (in severe cases)

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Gastric Variceal Bleeding