- Blood clots (of the splenic, portal, or hepatic veins).
- Arterial-portal venous fistula (abnormal connections between arteries and veins in the liver or spleen).
- Certain drugs (arsenic, azathioprine, methotrexate, and others).
- Certain infections (for instance, schistosomiasis, a parasite).
- Severe heart failure.
- Tumor in pancreas.
- Hodgkin's Lymphoma.
- Chronic vital hepatitis.
- NSAID use.
- Chronic hepatitis.
- Disorders of blood clotting.
- Certain parasitic infections.
- Endoscopy-a small, flexible tube attached to a light and camera is inserted into the mouth down into the esophagus and stomach to view the source of any bleeding and swollen vessel.
- Ultrasound -useful imaging modality to study blood flow in the portal system.
- If your esophageal variciform appear to have a very high risk of bleeding, your doctor may recommend a procedure called band ligation. Using an endoscope, the doctor snares the varices and wraps them with an elastic band, which essentially "strangles" the veins so they can't bleed. Esophageal band ligation carries a small risk of complications, such as scarring of the esophagus.
- Your doctor may also recommend a procedure called transjugular intrahepatic portosystemic shunt (TIPS). The shunt is a small tube that is placed between the portal vein and the hepatic vein, which carries blood from your liver back to your heart. By providing an additional path for blood, the shunt reduces pressure in the portal vein and often stops bleeding from esophageal variciform.
- Liver transplantation. Liver transplant is an option for people with severe liver disease or those who experience recurrent bleeding of esophageal variciform. Although liver transplantation is often successful, the number of people awaiting transplants far outnumbers the available organs.
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