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Complications
By Mayo Clinic staffThe most serious complication of esophageal varices is bleeding. Once you have had a bleeding episode, you're at greatly increased risk of another, especially immediately following the first episode.
Recurrent bleeding is common in people with esophageal varices — up to 70 percent will bleed again within one year of the first episode of bleeding without treatment. The likelihood of death increases with each episode. You're at greater risk of repeat bleeding if you are older, have liver failure or kidney failure, or drink alcohol.
Other complications of bleeding esophageal varices include:
- Hypovolemic shock. This occurs when your body loses some, often at least one-fifth, of its blood volume. Symptoms include low blood pressure, a rapid pulse, weakness, sweating, anxiety, mental confusion and possibly unconsciousness.
- Encephalopathy. A damaged liver is less effective at removing toxins from your body — normally one of the liver's key tasks. The buildup of toxins can damage your brain, leading to changes in your mental state, behavior and personality (hepatic encephalopathy). Signs and symptoms include forgetfulness, confusion and mood changes, and in the most severe cases, delirium and coma.
- Infection. Aspiration pneumonia, which occurs when you inadvertently inhale vomit or other substances into your lungs, can be a life-threatening complication of bleeding varices or of certain treatments to control them.
- Dite P, et al. World Gastroenterology Organisation Practice Guidelines: Esophageal Varices. World Gastroenterology Organisation. http://www.worldgastroenterology.org/assets/downloads/en/pdf/guidelines/18_treatment_e_varices_en.pdf. Accessed Aug. 21, 2008.
- Sanyal, AJ. General principles of the management of variceal hemorrhage. http://www.uptodate.com/home/index.html. Accessed Aug. 21, 2008.
- Runyon, BA. Patient information: Screening for esophageal varices. http://www.uptodate.com/home/index.html. Accessed Aug. 21, 2008.
- Goff JS. Endoscopic variceal ligation. http://www.uptodate.com/home/index.html. Accessed Aug. 21, 2008.
- Portal hypertension. Merck Manuals Online Medical Library. http://www.merck.com/mmhe/print/sec10/ch135/ch135d.html. Accessed Aug. 21, 2008.
- Sanyal, AJ. Prediction of variceal hemorrhage. http://www.uptodate.com/home/index.html. Accessed Aug. 21, 2008.
- Sanyal, AJ. Treatment of active variceal hemorrhage. http://www.uptodate.com/home/index.html. Accessed Aug. 21, 2008.
- Sanyal, AJ. Primary prophylaxis against variceal hemorrhage in patients with cirrhosis. http://www.uptodate.com/home/index.html. Accessed Aug. 21, 2008.
- Sanyal, AJ. Prevention of recurrent variceal hemorrhage in patients with cirrhosis. http://www.uptodate.com/home/index.html. Accessed Aug. 20, 2008.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. Aug. 24, 2008.
