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Word of the Day

varix

(var′iks)
(var′ĭ-sēz″)
pl. varices [L. varix, twisted or dilated vein]

1. A tortuous dilatation of a vein.
SEE: varicose vein
2. Less commonly, dilatation of an artery or lymph vessel.
A direct communication between an artery and a varicose vein without an intervening sac. A varicosity or dilation of an artery. A varix of a lymphatic vessel that conveys chyle. A tortuous dilatation of an esophageal vein, esp. in the distal portion. It results from any condition that causes portal hypertension, typically cirrhosis of the liver. Müller's maneuver; Nursing Diagnoses Appendix


ESOPHAGEAL VARIX IN A PATIENT WITH CIRRHOSIS OF THE LIVER Courtesy of John Roberts, MD

SYMPTOMS
If an esophageal varix bursts, massive hemorrhage occurs, and the patient may die within minutes.

TREATMENT
Medical treatment includes administration of a beta blocker, such as nadolol, with a nitrate, such as isosorbide, to lower portal pressures and decrease the likelihood of variceal bleeding. Invasive therapies include the injection of sclerosing agents or rubber banding of the dilated vein.

PATIENT CARE
Bleeding esophageal varices constitute a medical emergency, requiring immediate treatment to control hemorrhage and prevent hypovolemic shock. The patient’s vital signs, oxygen saturation, arterial blood gases, electrolyte and fluid volume balance, and level of consciousness are closely monitored. Intravenous access must be established promptly and fluid resuscitation, followed by transfusion and the administration of plasma are critical to early stabilization of the patient. Medical therapies also include the use of vasoconstricting drugs, such as vasopression. Endoscopy is used to identify the site of the ruptured vessels which may then be treated with sclerotherapy, ligation, or banding.

Surgical procedures to prevent rebleeding include portocaval or mesocaval shunts, portosystemic anastomosis, splenorenal shunting or liver transplantation. All procedures are explained, sensation messages provided, and reassurance and emotional support offered.
Dilatation of a lymphatic vessel. Permanent dilatation of veins of turbinate bodies. RSS FEED

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