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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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Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
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Endoscopic Ultrasound (EUS) and FibroScan are valuable diagnostic tools in gastroenterology and hepatology, each with specific applications and techniques.
Endoscopic Ultrasound (EUS):
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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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Related Experiment Video

Updated: Jul 19, 2025

Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
07:10

Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy

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Viscoelastometry to Manage Bleeding in Liver Disease.

Samantha Wilson1, Joanne Joseph2,3, Mark Danta1,4

  • 1Gastroenterology and Hepatology, School of Clinical Medicine, St. Vincent's Healthcare Campus, Faculty of Medicine, University of New South Wales, Sydney, AUS.

Cureus
|August 7, 2023
PubMed
Summary
This summary is machine-generated.

Viscoelastic testing (VET) offers a comprehensive assessment of coagulation in liver disease patients, unlike standard tests. VET accurately predicts bleeding risk and guides transfusions, improving patient outcomes.

Keywords:
bleedingcirrhosisliver diseasethrombosisviscoelastometry

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Area of Science:

  • Hepatology
  • Hematology
  • Clinical Coagulation

Background:

  • Liver disease causes complex hemostasis alterations, affecting clotting and anticoagulant proteins, platelets, and fibrinolysis.
  • Conventional coagulation tests (PT, INR, aPTT) are insensitive to these multifaceted changes and may not reflect true bleeding risk.
  • Standard tests primarily assess clotting factor quantity, overlooking natural anticoagulant levels crucial in liver disease.

Purpose of the Study:

  • To critically review the data on viscoelastic testing (VET) in patients with liver disease.
  • To assess VET's role in predicting bleeding risk and guiding transfusion strategies in this population.
  • To provide a detailed overview of VET's current clinical utility for liver disease patients.

Main Methods:

  • Review of existing research on viscoelastic testing (VET) in liver disease.
  • Analysis of VET's parameters including coagulation factor function, platelet contribution, and fibrinolysis.
  • Comparison of VET's predictive capabilities against conventional coagulation tests.

Main Results:

  • VET provides a more comprehensive assessment of hemostasis compared to standard coagulation tests.
  • VET has established utility in liver transplantation and is being researched for other invasive procedures and bleeding complications in liver disease.
  • VET parameters offer insights into coagulation factor function, platelet activity, and fibrinolysis.

Conclusions:

  • Viscoelastic testing (VET) is a valuable tool for assessing complex hemostasis in liver disease.
  • VET accurately predicts bleeding risk and can guide transfusion support more effectively than conventional tests.
  • Further research supports the expanded clinical application of VET in managing liver disease patients.