تعريف

Esophageal varices are abnormal blood vessels that develop in the esophagus. They have abnormally thin walls and the blood pressure within them is very high. This combination makes esophageal varices dangerous, because they can burst and cause life-threatening bleeding.

Esophageal variceal injection is a procedure to either prevent future bleeding or stop active bleeding. During the procedure, medicine is injected into or alongside esophageal varices. When injecting into the vein, the medicine causes blood clots to form, blocking the vein from bleeding. When injected alongside the vein, the swelling in the area compresses the vein, preventing it from bleeding.

The procedure is also known as sclerotherapy.

أسباب هذا الإجراء

Esophageal varices can be life-threatening. Esophageal variceal injection is a procedure that can make them less likely to bleed. The procedure is also used to stop active bleeding from esophageal varices.

المضاعفات المحتملة

Complications are rare, but no procedure is completely free of risk. If you are planning to have an injection, your سيقوم الطبيب بمراجعة القائمة of possible complications which may include:

  • Painful swallowing
  • Esophageal narrowing
  • نزيف
  • Esophageal damage
  • العدوى

بعض العوامل التي قد تزيد من خطر المضاعفات تشمل:

  • إدمان الكحول
  • اضطراب النزيف
  • Active bleeding
  • زيادة العمر
  • مشاكل في القلب أو الرئة

ما يمكن توقعه

قبل الإجراء

  • Do not eat for 8 to 12 hours before the procedure.
  • If you have diabetes, discuss your medicines with your doctor.
  • Arrange for transportation after the procedure. You should not drive for 24 hours after the procedure.
  • التحدث مع طبيبك عن الأدوية الخاصة بك. قد يطلب منك التوقف عن تناول بعض الأدوية تصل إلى أسبوع واحد قبل العملية مثل:
    • الأسبرين أو غيره من العقاقير المضادة للالتهابات
    • مميعات الدم ، مثل كلوبيدوجريل أو وارفارين

التخدير

  • Your throat may be sprayed with a medicine to make it numb.
  • You will be given IV medicines to help you relax.
  • If you have active bleeding, it may be necessary to use general anesthesia. You will be asleep.

وصف الإجراء

For this procedure, you will lie on your left side. A mouthpiece will be placed to help keep your mouth open. An assistant will be in the room to monitor your breathing and heart beat. You may also be given oxygen through your nose. A suction tube will be used to clear the saliva and other fluids from your mouth.

A lubricated endoscope will be placed into your mouth. It will be passed down your throat and into your esophagus. The scope will have a small light and a camera. Images will display on a video monitor. Air will be passed through the scope to help your doctor see your esophagus. The enlarged vein will be located. If needed, the endoscope can be passed all the way down into the stomach and upper intestines.

تنظير الجهاز الهضمي العلوي

When near the varices, a flexible needle will be passed through the scope. The needle will be used to inject medicine into the varices. If needed, your doctor may do many injections during one procedure.

Instruments can also be passed through the scope to apply rubber band-like devices. The rubber band ties off the varices. This will prevent future bleeding. This is called band ligation.

كم من الوقت سيستغرق ؟

حوالي 30-60 دقيقة

كم هو مؤلم ؟

During the procedure, you may feel discomfort in your throat. After the procedure, your throat may be sore for a few days. In addition, you may feel bloated and need to belch. It may also be painful to swallow for a يومان after the procedure.

رعاية ما بعد العملية

After the procedure, be sure to follow your doctor’s instructions , which may include:

  • Do not drive for at least 24 hours.
  • Rest the remainder of the day.
  • Resume your normal diet, unless told otherwise by your doctor.
  • Resume your medicines, unless told otherwise by your doctor.
  • If you stopped your medicine before the procedure, ask your doctor when it is safe to start taking it again.

After this procedure, you will have a smaller chance of bleeding from your esophageal varices. However, it is still possible to bleed from varices that have been injected. More than one procedure may be required.

استدعاء الطبيب

بعد وصوله الى المنزل ، اتصل بطبيبك إذا كان أي من الحالات التالية:

  • علامات الإصابة, بما في ذلك حمى وقشعريرة
  • Bleeding from the mouth
  • Increasing pain
  • استفراغ و غثيان
  • Bloody vomit
  • صعوبة في البلع
  • السعال، ضيق التنفس، أو ألم في الصدر
  • الدوار
  • Bloody or dark black stools
  • ألم شديد في البطن

في حالة الطوارئ ، اتصل على المساعدة الطبية على الفور.

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