Bleeding in cirrhosis of the liver - a serious complication of the disease. It is characterized by rapid development. If there is not provided timely assistance, you may develop a state of shock, resulting in death. To determine the cause of bleeding, resorting to laboratory hardware and research methods. The therapy carried out by means of drugs or surgery is performed.
Causes
The reasons of occurrence of bleeding include:
- Portal hypertension. liver tissue begin to grow, there is poor circulation, resulting in vein organ increases blood volume. This leads to an increase in internal pressure and vascular damage.
- Varicose veins of the intestines, stomach and esophagus. Most often, massive blood loss observed in the area where the esophagus enters the stomach. Advanced varicose veins made convex and start to act in the lumen of the problem area. Due to the prolonged stagnation of blood vessel can burst.
- Bleeding disorder. In cirrhosis of the liver healthy tissue is replaced by fibrous begin, the body stops the production of enzymes that are responsible for blood clotting.
- The negative impact on the gastric juice thinned vascular wall. When liver disease is a malfunction of the digestive system, whereby the stomach contents thrown up into the esophagus. This irritates artery and vein, which leads to bleeding from the esophagus in liver cirrhosis.
Bleeding in cirrhosis develops rapidly and quickly leads to the death of a person.
symptomatology
The fact that the developed internal bleedingIndicate the following features:
- Vomiting blood. Vomit becoming dark because red blood cells are destroyed by stomach acid.
- Dizziness, unpleasant taste in the mouth, general weakness. The skin becomes pale hue, the chair is sticky and dark. When there is severe anemia increased sweating.
- Nausea, drowsiness, man always sleepy. A few hours after the onset of bleeding stools are black.
At moderate blood loss (500-1000 ml), the general condition of the patient begins to deteriorate. He is restless and nervous. There are the following symptoms: a skin grayish hue, tachycardia, decrease in blood pressure and body temperature.
Severe hepatic bleeding in which the blood loss is more than 1.5 liter of blood, accompanied by a state of shock, blueness of the skin, sticky appearance of sweat. Pulse rate, the pressure is reduced to a critical level. If the blood loss will be more than 2 liters, comes death.
Treatment
If there was bleeding in liver cirrhosis, the patient is placed in an intensive care unit. By conservative methods of treatment include:
- Tamponade. In the esophagus through the oral cavity probe is inserted. Cuff unit is filled with air, which leads to compression of bleeding vessels.
- Receiving hemostatic drugs. To reduce the bleeding intensity gastroenterologist assigns drugs to help reduce the pressure in the portal vein. These include vasopressin, octreotide. To increase blood clotting using drugs containing VITAMIN K (Vikasol).
- The use of agents that make up the loss of blood. Carried intravenous solution hydroxyethylated starch or sodium chloride. If excessive bleeding poured packed red blood cells or plasma.
- Receiving proton pump inhibitors (Pantoprazole, omez). With their help, reduced irritant effect of hydrochloric acid, which avoids re vascular injury.
Surgical methods of treatment used in some cases:
- Carry out hardening of damaged vessels. With this method of treatment in the vascular lumen using endoscopic instruments introduced 70% ethyl alcohol or Varikotsid. Such tools do not allow to stick the vascular wall.
- Sutured to the stomach or esophagus vessels.
- Vein ligated latex rings.
- Excised damaged vascular areas.
- Form of hepatic veins artificial workarounds blood flow. This reduces the pressure in the veins of the esophagus.
- Remove part of the esophagus and stomach. Carry out such an operation for bleeding, which threaten the life of the patient.
Forecast
Complications that causes bleeding, attributed the disruption of all body systems. If there was bleeding in cirrhosis of the liver, the prognosis will depend on how hard the disease occurs, and the amount of blood lost. The probability of death increases with ascites and hyperbilirubinemia.
In such cases, after the opening of the bleeding observed rapid destruction of 35% of patients. Even if doctors manage to stop the loss of blood, then 1-2 weeks in 40% of cases relapse occurs. Often in patients with impaired brain functioning and developing malignant tumors in the liver.
