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Related Concept Videos

Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
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Varicose Veins II: Diagnostic Studies and Interprofessional Care01:26

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Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
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Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Esophageal Varices-I: Introduction01:24

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Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
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Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

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Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
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Peptic Ulcer Disease IV: Management01:26

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Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
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Pharmacological management
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Related Experiment Video

Updated: Jan 2, 2026

Underwater Endoscopic Injection Sclerotherapy for Gastroesophageal Varices
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Treating Untreatable Rectal Varices.

Mónica Garrido1, Belarmino Gonçalves2, Sofia Ferreira3

  • 1Department of Gastroenterology, Porto University Hospital Centre, Porto, Portugal.

GE Portuguese Journal of Gastroenterology
|December 14, 2019
PubMed
Summary

Transjugular intrahepatic portosystemic shunt (TIPS) combined with embolization effectively treated refractory rectal variceal bleeding in a cirrhotic patient. This radiological approach offers a viable solution for managing severe gastrointestinal bleeding.

Keywords:
Liver cirrhosisRectal varicesTherapeutic embolizationTransjugular intrahepatic portosystemic shunt

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Area of Science:

  • Gastroenterology
  • Interventional Radiology
  • Hepatology

Background:

  • Rectal varices are portosystemic collaterals resulting from portal hypertension, commonly seen in cirrhotic patients.
  • While prevalent, significant bleeding from rectal varices occurs in a minority of cases.
  • Endoscopic therapies are common, but refractory bleeding may require interventional radiology or surgery.

Observation:

  • A 61-year-old male with hepatic cirrhosis presented with rectal varices refractory to endoscopic treatment.
  • The patient's bleeding was successfully managed using a combination of transjugular intrahepatic portosystemic shunt (TIPS) and selective variceal embolization.

Findings:

  • The combined radiological approach of TIPS and embolization proved effective in achieving hemostasis.
  • This case demonstrates the successful application of interventional radiology for refractory rectal variceal bleeding.

Implications:

  • Radiological interventions, particularly TIPS with embolization, are effective for managing refractory rectal variceal bleeding.
  • This combination therapy represents a valuable option for hemostasis in recurrent cases, potentially reducing the need for more invasive procedures.