PDF(Pubmed)
Abstract：
Esophageal varices are life-threatening complications in which the enlargement of the esophageal veins causes bleeding and reduces blood flow to the esophagus. They are complications caused by portal hypertension, renal failure, hepatic dysfunction, and infection. The leading cause of esophageal varices is cirrhosis, as patients with this disease are more susceptible to forming esophageal varices. Bleeding episodes occur due to the rupture of the blood vessels. We present the case of a 45-year-old male patient in the hospital with a history of chronic alcohol use and clinical symptoms of hematemesis, a distended abdomen, and melena. The patient experienced mild symptoms of giddiness and dizziness after undergoing various radiological investigations, laboratory tests, ultrasonography (USG), and CT scans. USG diagnosed portal hypertension, gross ascites, pleural effusion, and hepatosplenomegaly. A CT scan diagnosed the patient with esophageal varices and testicular carcinoma. Laboratory tests diagnosed anemia. The treatment plan included oral and intravenous iron supplements, blood transfusions, vitamin B12, folate supplements, and nonselective beta-blockers to manage portal hypertension and reduce variceal bleeding risk. During acute bleeding episodes, vasoconstrictors and endoscopic band ligation were employed. Regular endoscopies and hepatic venous catheterization were conducted to monitor and manage the condition. Follow-up included regular assessments of hemoglobin levels, iron status, liver function tests, and periodic endoscopies. The patient\'s adherence to beta-blockers was closely monitored. Esophageal varices, often resulting from portal hypertension because of cirrhosis, require early diagnosis and a combination of pharmacological and endoscopic treatments to prevent complications. Advances in treatment have reduced mortality rates, but effective management of portal hypertension and liver dysfunction remains crucial.
摘要：
食管静脉曲张是危及生命的并发症，其中食管静脉的扩大会导致出血并减少流向食管的血液。它们是门静脉高压引起的并发症，肾功能衰竭,肝功能障碍,和感染。食管静脉曲张的主要原因是肝硬化，因为这种疾病的患者更容易形成食管静脉曲张。由于血管破裂而发生出血发作。我们介绍了该医院一名45岁的男性患者，该患者有长期饮酒史和呕血的临床症状，腹部膨胀，还有Melena.患者在接受各种放射学检查后出现轻微的头晕和头晕症状,实验室测试,超声检查（USG），和CT扫描。USG诊断为门静脉高压症，恶心腹水，胸腔积液,和肝脾肿大.CT扫描诊断该患者患有食管静脉曲张和睾丸癌。实验室检查诊断为贫血。治疗计划包括口服和静脉注射铁补充剂，输血,维生素B12，叶酸补充剂，和非选择性β受体阻滞剂治疗门静脉高压症和降低静脉曲张破裂出血风险。在急性出血发作期间，采用血管收缩剂和内窥镜带结扎术。定期进行内窥镜检查和肝静脉置管以监测和管理病情。随访包括定期评估血红蛋白水平，铁的状态，肝功能检查,和定期内窥镜检查。密切监测患者对β受体阻滞剂的依从性。食管静脉曲张,通常是肝硬化导致的门静脉高压症，需要早期诊断和药物和内镜治疗相结合，以防止并发症。治疗的进展降低了死亡率，但是有效管理门静脉高压和肝功能障碍仍然至关重要。
