Hva er øsofagusvaricer?

Øsofagusvaricer er utvidete vener, eller åreknuter, som først og fremst kan påvises i de nedre 5 cm av spiserøret (øsofagus). Tilstanden er et resultat av økt trykk i venekretsløpet. Disse åreknutene har lett for å sprekke og begynne å blø. Slike blødninger er ofte livstruende.
Annonse
Den vanligste årsaken til et slikt økt venetrykk er skrumplever, og denne tilstanden er nært knyttet opp mot alkoholmisbruk, eller sjeldnere en kronisk leversykdom av annen årsak. Hver tredje person med skrumplever kan få variceblødning.
Blant pasienter med levercirrhose er det en årlig risiko på 7% for å utvikle varicer.
Vil du vite mer
Dette dokumentet er basert på det profesjonelle dokumentet Øsofagusvaricer . Referanselisten for dette dokumentet vises nedenfor
Referanser
- Sanyal AJ. General principles of the management of variceal hemorrhage. UpToDate, last updated Feb 21, 2017. UpToDate
- D'Amico G, Malizia G. Oesophageal varices. BMJ Best Practice, last updated Jan 2017.
- Sanyal AJ. Primary prophylaxis against variceal hemorrhage in patients with cirrhosis. UpToDate, last updated Nov 29, 2010. UpToDate
- Sanyal AJ. General principles of the management of variceal hemorrhage. UpToDate, last updated July 22, 2014. UpToDate
- Sharara AI, Rockey DC. Gastroesophageal variceal hemorrhage. N Engl J Med 2001; 345: 669-81. PubMed
- D'Amico G, Pagliaro L, Pietrosi G, Tarantino I. Emergency sclerotherapy versus vasoactive drugs for bleeding oesophageal varices in cirrhotic patients. Cochrane Database of Systematic Reviews 2010, Issue 3. Art. No.: CD002233. DOI: 10.1002/14651858.CD002233.pub2. DOI
- Ioannou GN, Doust J, Rockey DC. Terlipressin for acute esophageal variceal hemorrhage. Cochrane Database of Systematic Reviews 2003, Issue 1. Art. No.: CD002147. DOI: 10.1002/14651858.CD002147. DOI
- Chan LY, Sung JJ. The role of pharmacotherapy for acute variceal haemorrhage in the era of endoscopic haemostasis. Aliment Pharmacol Ther 1997; 11: 45. PubMed
- Gøtzsche PC, Hróbjartsson A. Somatostatin analogues for acute bleeding oesophageal varices. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD000193. DOI: 10.1002/14651858.CD000193.pub3. DOI
- Chavez-Tapia NC, Barrientos-Gutierrez T, Tellez-Avila FI, Soares-Weiser K, Uribe M. Antibiotic prophylaxis for cirrhotic patients with upper gastrointestinal bleeding. Cochrane Database of Systematic Reviews 2010, Issue 9. Art. No.: CD002907. DOI: 10.1002/14651858.CD002907.pub2 DOI
- Hou MC, Lin HC, Liu TT et al. Antibiotic prophylaxis after endoscopic therapy prevents rebleeding in acute variceal hemorrhage: a randomized trial. Hepatology 2004; 39: 746-53. PubMed
- Laine L, Cook D. Endoscopic ligation compared with sclerotherapy for treatment of oesophageal variceal bleeding. Ann Intern Med 1995; 123: 280-7. Annals of Internal Medicine
- Hou H-C, Lin H-C, Kuo I-T, Lee F-Y, Chang F-Y, Lee S-D. The rebleeding course and longterm outcome of esophageal variceal hemorrhage after ligation: comparison with sclerotherapy. Scand J Gastroenterol 1999; 34: 1071-6. PubMed
- Brenna E, Flaaten B, Waldum HL, Myrvold HE. Behandling av oesophagusvaricer med strikkligatur. Tidsskr Nor Lægeforen 2000; 120: 2626-9. Tidsskrift for Den norske legeforening
- Wright AS, Rikkers LF. Current management of portal hypertension. J Gastrointest Surg 2005; 9: 992-1005. PubMed
- Groszmann RJ, Garcia-Tsao G, Bosch J, et al. Beta-blockers to prevent gastroesophageal varices in patients with cirrhosis. N Engl J Med 2005; 353: 2254-61. New England Journal of Medicine
- Ge PS, Runyon BA. The changing role of beta-blocker therapy in patients with cirrhosis. J Hepatol 2014; 60: 643-53. pmid:24076364 PubMed
- Feu F, Garcia-Pagan JC, Bosch J, et al. Relation between portal pressure response to pharmacotherapy and risk of recurrent variceal haemorrhage in patients with cirrhosis. Lancet 1995; 346: 1056-9. PubMed
- Romero G, Kravetz D, Argonz J, et al. Comparative study between nadolol and 5-isosorbide mononitrate vs. endoscopic band ligations plus sclerotherapy in the prevention of variceal rebleeding in cirrhotic patients: a randomized controlled trial. Aliment Pharmacol Ther 2006; 24: 601-11. PubMed
- Zoli M, Merkel C, Magalotti D, et al. Natural history of cirrhotic patients with small esophageal varices: a prospective study. Am J Gastroenterol 2000; 95: 503-8. PubMed
- Mukherjee S, Sorrell MF. Beta-blockers to prevent esophageal varices - an unfulfilled promise. N Engl J Med 2005; 353: 2288-90. PubMed
- Goulis J, Patch D, Burroughs A. Bacterial infection in the pathogenesis of variceal bleeding. Lancet 1999; 353: 139-42. PubMed
- D'Amico, de Franchis R, a Cooperative Study Group. Upper digestive bleeding in cirrhosis. Hepatology 2003; 38: 599-612. PubMed
- Bosch J, Garcia-Pagan JC. Prevention of variceal rebleeding. Lancet 2003; 361: 952-4. PubMed
- de Franchis R; Baveno VI Faculty. Expanding consensus in portal hypertension: report of the Baveno VI consensus workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol. 2015;63:743-752. PubMed