Esophageal Varices & Variceal Hemorrhage Treatment and Managment(STEP WISE APPROACH)
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- Опубликовано: 19 июл 2020
- Esophageal Varices & Variceal Hemorrhage Treatment and Managment(STEP WISE APPROACH)
esophageal varices hemorrhage and its management is boards favorite exam topic.this video will explain step wise managemnt of upper GI bleed and variceal bleeding.if you are preparing for USMLE STEP 2 CK or PLAB then you have come to the right channel subscribe for my more videos on these topics.
An overview of the pathogenesis of esophageal varices and the treatment of acute GI bleeds in cirrhosis. Also covered are the basic anatomy of the hepatic portal system, and TIPS (transjugular intrahepatic portosystemic shunts).
What is portal hypertension? Portal hypertension means increased blood pressure in the hepatic portal system - or portal venous system. Most commonly, this happens because of hepatic cirrhosis, which is when the liver tissue is replaced by fibrotic, functionless tissue.
Banding, Bleeding, Cirrhosis, and complications of esophageal varices. What should the nurse know and how should they take care of the patient.
Bleeding varices is a condition characterized by bleeding in abnormal vessels.
• Varices are abnormal connections between the systemic and portal circulation present in the body.
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• Varices commonly occur in the venous system, but they may sometimes occur in arterial or lymphatic vessels.
• The most common site of varices is the esophagus although they can appear at other sites in the gastrointestinal such as the stomach, rectum, or around the belly button.
• If the bleeding is not controlled fast, a person may go to shock and eventually die.
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IMPORTANT POINTS:
Administer Terlipressin 2mg IV repeated every 4 to 6 hours.
Some guidelines(i.e NICE guidelines) recommend avoiding use of PPI unless patient has known peptic ulcer disease.
Administer Platlet Transfusions to patients who are actively bleeding and have platlet count less than 50,000.
Give Vit K to patients if INR is prolonged.
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Sir what about Transexamic acid???
why i didnt find your channel at start of my final year!!!! .....best lectures.....
You're by far the best teacher I've come across, I wish I had someone in medical school to teach concepts in such an easy to understand manner. thank you, Dr Fazal!
This flow chart has made such lengthy topic so easy.
Thank you Dr usman 😊
What an excellent way of teaching Medicine !
Thank you wahab! ❤️
Came here from Armando hasadagun’s channel....your vedios and way of explaining things are simply amazing sir...you actually got a subscriber!
Thank you very much Farhana! I am really glad that you liked it. 🙂
Excellent explanation! Thank you.
Wow ,,,, a difficult topic made so easy and conceptual.... thnx a lot sir
Best channel to learn management of diseases so far👏
Excellent and consice concept, thank you sir.
Very good revision
Keeps me on my toes and highlights my errors
Thank you Kamal! ❤️
Beautifully explain management 🌟
Explained very well 💯
Great sir, your videos are amazing and to the point
Very nice explaination!!!
The Way of explaining❤really loved it!!!
Thank you Abhijit. 😊
Outstanding lecture 👌🇮🇳
Very nicely described...
excellent concept!
Beautiful lecture 💗💗
Simple yet excellent ❤
Perfect,thank you
Nice explanation..thank you ❤
Too good!!
Awesome 👍
Well done doc. Your are one of the best. This is an excellent teaching. Thank you.❤❤❤❤❤❤❤
So kind of you. I read all of your comments. I am very happy that you found my videos helpful. Keep supporting 😊
Excellent sir
Thank you sir!
Sir am 1st saw your ecg video....then i follow only your channel in medicine
Excellent
Great sir
Amazing 🤩
Sir Almost done ✅..i have seen most ...only few remain...if possible please do hematology part.
This was very impressive and easy to follow.
It's true only
Very nice
Wonderful presentation, for how long will the patient with TIPS receive Lactulose?
Mash Allah ❤️
very good explanation ...help me to understand it...thanks man
Thank you. I am glad it helped you. 😊
A big waoo..🙌
Itna awsm video maine aaj tak nahi dekha..practial explanation part was very good..
Yeh topc kabi smjh nahi aata tha..
Par ab aagya..
Thanks!!!
Thank you very much Varshu Pandey... I am glad you found it helpful 🙂
You made it so simple and easy
Thank you waris!
thankyou so much sir
explained very well sir, great job
Thank you furqan ❤️
Plz make videos on respiratory system.
Thank u
Nice
Excellent💯👍 describe sir ji
Thank you Ramesh Kumawat :)
This happened to me 1month ago. I lost over 2 litres of blood. However I am a 28 year old with a healthy liver and minimal alcohol consumption. Still waiting to learn what the route cause is.
Willing to know if a cirrohtic patient's haemoglobin is falling too quickly then can he go for endoscopic variceal ligation inorder to prevent the internal bleeding?? & can the patient have a stable haemoglobin rate after endoscopic variceal ligation?
Great work MA ♥️
Thank you Saad ❤️
Explained well💓
Thank you Dr Qasim!
Good explanation!
Thank you Shayan! 😊
Sir you are excellent teacher
Thank you 😊
Sir if propranolol causes vasoconstriction by blocking beta2 receptor, it should increase the pressure in the portal circulation right... So how is it going to relieve portal hypertension?
As we have studied, vasoconstriction causes increased peripheral resistance and therefore blood pressure increases
AFTRR doing all these procedures how will be the prognosis 0f patient
Dr sb are their ways people could have known about these varicose before developing
Sir ur videos are very informative and easy to understand. Pls make a video on peptic ulcer,thank you .
Sure I will. thank you :)
What is the dose of octreotide and total duration??
Hi dctr fr my father also liver cirrosis he s a non alcholic an fr this treatment is there r nt pls tell me dctr tld me in endosocopic report thr s large eshopegus varices with rcs
What to do when bleeding is not stopping then how to do endscopy
Can we go for transplant at this stage?
Can broken blood vessels or varicose veins in the esophagus repair itself naturally?
Wow, clicked through cus I saw a comment of yours on medcram. Really dig this explanation, and I have no medical background whatsoever. So what's life like for people who've had to have TIPS performed on them? Do they lose all liver function or does it retain some of its functionality?
Thank you very much for such nice comments. I am glad you understood everything. Patients who get TIPS are the ones who have really bad cirrhotic liver that has already lost much of its function. One study trial shows that people undergoing TIPS procedure live upto 2 years on average & 5 years at max. Complication of ammonia toxicity and accumulation is treated by lactulose if not controlled, rifaximin is administered. TIPS is done to control variceal only when we have exhausted all other options.
@@MedNerdDrWaqasFazal dang, sounds like a brutal way to go. Thanks for the explanation again! Keep up the awesome work! These are very informative!
What about Transexamic acid in acute Mx???
I am not a medical student. But my mother's esophageal varices surgery has done. So I came here to know well. Does she need to take lactulose syrup on a daily basis?
Sir I am hepatitis b liver cirrhosis patient with portal hypertension dilated portal vein and small esophagal varices with splenomegaly detected with high viral using tenofovir after 25 mg and carvediol 6.25 mg twice will it stop bleeding can I leave normal life with medications pls reply sir pls understand I am fear
Sir, My mother has been detected with Esophagus variaces Grade-3.
How serious is the disease doctor.
Please respond🙏🙏
Aslam alekum sir
Sir is R/L safe in CLD will it not cause raised lactate level
And sir what about use of tranxemic acid in acute management of hemaptasis
Sir kindly made another video on this topic. we also want to know that how many days b blockers may be continued. Also terlipressin. How many days we continue antibiotics and which antibiotics are we should continue
Sure I will upload another video in more detail. 😊
Sir,this problem is seen of father in law.How can we contact with you?
Sir what is PARTO?
Do we do band ligation only when the pt is hemodynamically stabilized? I’m a new nurse sorry if its a silly question.
All the steps must be taken to stabilise the patient first after which you can go for endoscopy and band ligation. Band ligation can also be considered as a part of stabilisation of patient as to stop further bleeding.
@@MedNerdDrWaqasFazal thank you
Sir My mother is suffer hypertension...
🎉
Amazing teacher but very fast
and dosage of octreotide is 50mirogram bolus then 50micro per hour ifusion
No full stop . Highly difficult to take notes
Don't waste ur time , there is no permanent treatment in medical for esophagus varies
only homeopathic is best way to treat