- dilated and tortuous vessels of in the esophagus
- Risk Factor
§ Irritation from gastric acid
§ Vomiting
- Etiology: increase pressure in the portal venous system
- Clinical Manifestations
§ Hematemesis
§ Melena
§ Ascites
§ Jaundice
§ Abdominal vein distention
§ Hemorrhoids
- Diagnostics
§ Guaiac test
§ Ultrasound
§ Endoscopy
- Management
§ Vasopressin to induce vasoconstriction and prevent hemorrhage
§ Nitroglycerine for vasodilation in the peripheries to reduce pressure
§ Beta blockers
§ IV fluids
§ Oxygen
§ Sclerotherapy
§ Endoscopic variceal ligation
§ Balloon Tamponade
· Sengstaken-Blakemore tube – triple lumen tube with ports for inflation of esophageal balloon, inflation of gastric balloon and aspiration of gastric contents
· Minnesota Tube – same as above but with another lumen for aspiration of the esophageal contents
· Linton Tube – single lumen tube with only two ports
- Nursing Intervention
§ Client is on NPO
§ Monitor Hgb and Hct
§ Monitor VS and urine output
§ Monitor level of consciousness
§ Assess for respiratory distress especially after insertion of balloon- if it occurs deflate balloon immediately
§ Keep scissors at bedside all times to cut immediately the balloon tube if respiratory distress occurs
§ Monitor amount of drainage
§ Watch out for signs of shock
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