Common varicose veins
In category II, all large trunks are processed in a spiral from the cardia upward; rings are applied to the most tense nodes and areas with “red signs” - harbingers of a rupture. Observation in the ward for a day (the risk of early hemorrhage is minimal, but monitoring is mandatory), pain relief and PPI. The next session is planned in 3-4 weeks: usually 2-3 procedures are required until the veins are completely replaced with scars, which is confirmed by a control endoscopy. In parallel, therapy for portal hypertension is adjusted.
Indications
- varicose veins of the esophagus grade 2–3 with cirrhosis - primary prevention of bleeding;
- bleeding from varicose veins - secondary prevention (staged eradication);
- acute bleeding from the veins of the esophagus - emergency hemostasis;
- intolerance/insufficiency of beta blockers.
Why ligate veins?
Bleeding from varicose veins of the esophagus is the most serious complication of cirrhosis with high mortality; ligation with latex rings is the standard for preventing and stopping it: the nodes are thrombosed and replaced by a scar, the risk of bleeding is reduced by 3–4 times. Eradication is achieved in 2–4 stage sessions with an interval of 3–4 weeks; The price category reflects the volume of varicose veins and the number of rings. The procedure is combined with taking beta blockers and treating the underlying liver disease; EGD monitoring is for life.
