Esophageal Varices and Variceal Hemorrhage

[@Bill.R.124]

Excellent video. All the others on here are very poor quality. I wish yours was a bit shorter, but going to use it in my advanced med/surg nursing course. You hit all the key points that even RNs should understand. As a seasoned ED nurse (and now nursing professor), one of the sickest patients I ever cared for was a man with EVs. He came in, having runs of Vtach, which confused me (they were simply due to his profound anemia). The ED docs saw him, ordered blood and never came back into the room. Having worked in a trauma center, I just started slamming the blood in, knowing how he could exsanguinate with another bout of hematemesis. So, the GI decided to scope him, which led to a blood bath. (His Hgb was only around 5). I insisted they intubate as I was afraid he was going to arrest and/or aspirate; they agreed. It was so difficult to secure his airway, that anesthesia had to be called down stat (luckily they were in house). The patient almost coded and I think my aggressive "tanking him up" of PRBCs and insisting they secure his airway, thwarted his demise. They ended up having to place a Blakemore and he was eventually treated with ligation or something. He left with no complications despite almost dying in the ED. Great case.

[@DrAdnan]

It’s cool how signs and symptoms in one part of the body show up in other areas

[@brandywalkenten9085]

My friend just passed away on Wednesday from this. Very sad. He was a raging alcoholic. 58 years old. I tried to get him into rehab but he would not go.

[@christyheffernan1248]

Please don’t take this upon yourself. Rehab will only work if someone is ready. Im very sorry for your loss.

[@Pitoleczek]

I am working on GI ward and i think its very usefull presentation. Keep doing this. Thanks a lot.

[@LaChana26]

I appreciate that Ave Maria is your intro/outro music. Also, your video was informative!

[@cornelbacauanu1544]

Super nice presentation . I placed my self, in the old days, the SB tube when Octreotide was not available and asked my self what will happen next … Thank you .

[@sunving]

Thank you Dr Strong , nice lecture, I am glad to run into your channel.

[@Testango]

wonderful video as always! It would be nice a video (or more) about congestive heart failure! Thanks doc

[@StrongMed]

Thanks! I definitely want to cover heart failure in the upcoming months, but it's a huge topic that will take a whole series, and which I want to be sure to do right. My own students cover heart failure in class during April and May, so ideally I would like to have the videos out by then. We'll see...

[@mikeecrozz]

Excellent video thank you so much! High yield lectures 💕

[@HafizahHoshni]

Awesomely informative and perfectly explained! Thank you so much! 😊😊 15/9/2019

[@usamashaikh6253]

Thank you so much man really appreciate the effort

[@deathcamp1]

i was doing clinical rotations and saw a patient code with one of her varices burst, she lost a little more than 2.5 L of her blood, they eventually stabilized her, didnt get to see what happened after that thought, pretty crazy stuff

[@avishekghosh8212]

Nicely explained

[@SKARTHIKSELVAN]

Thanks for your video.

[@dolgovbadaev1150]

Several studies have shown that the prevalence of internal hemorrhoids in portal hypertension is similar to that in the general population challenging the idea that portal hypertension plays any role in the development of hemorrhoids. Portal hypertension causes rectal varices which are different entities than hemorrhoids. Dr. Bat-R

[@BhBc8f8]

portal HTN leads to Internal hemorrhoids but it is not the only cause of internal hemorrhoids

[@Hedgeflexlfz]

Can you make a video in regards to eosinophilic esophagits? It's a disease that is increasing dramatically in prevalence.

[@StrongMed]

Thanks for the suggestion! Eosinophilic esophagitis is one of those diagnoses you almost never hear about in med school, and then suddenly you're in the hospital and it seems like every 4th or 5th EGD is finding it. (It's probably not literally that common, but sometimes it feels like it!) I'll put it on my list of viewer requests, though since the list is quite long, I can't offer a specific estimate of when I might get to it.

[@Hedgeflexlfz]

@@StrongMed Ok, thanks. I can tell that many doctors have no idea what it is. I went undiagnosed by my primary doctor for years. I was in the urgent care for an unrelated problem when I mentioned my dysphagia and symptoms to a doctor there. She referred me to a GI and noted that it was most likely an esophageal problem.

[@halfjarofmilk]

Thank you doc! Here’s a dietitian learning more about common patient admit diagnoses and how the body works :)

[@riss11able]

great video!

[@reinhardherr4338]

My partner just passed away from this yesterday. He was only 32 years old.

[@NS-jt4kg]

I found my dad passed away in a pool of blood 4 months ago. There wasn't an autopsy (high in emotion I said no, but regret it) but I suspect a GI (possibly a variceal) bleed. Since he was an alcoholic and just found out he had cirrossis. There was about half a liter of blood on the ground (bathroomfloor) and blood still came out when we moved him. The blood was pretty red(no lumps or other clots) no splatter, but there was a little bit on his pillow that was red when I walked into his house and brown when I called family and the funeral home so it must have been from the same bleed. There was feces in the toilet(he slipped off) and they were darker, but not black-ish and I feel like he lost consciousness before losing most of the blood(since there wasn't a lot of splatter). Could it still be a GI bleed? The doctor that called his death said probably a aneurysm, but does that much blood get out after that? There was like half a liter on the floor and still blood coming out of his nose and mouth when we moved him. There were no signs that the fall killed him according to the funeral home.

[@henrikhansen7462]

This is an upper GI bleeding considering his anamnesis and your findings which most likely coming from esophageal varices.

[@srirambhardwaj2343]

Thank.you.very.much.sir.

[@mrehteshamjavaid]

I think Out of All mentioned Acute Complications of Cirrhosis, I am left with Only HepatoRenal Syndrome!

[@StrongMed]

Coming next week!

[@je6874]

Octreotide vs Terlipressin?

[@SkeppGlocc]

How do I stop this man. I’m in pain so badly.

[@StrongMed]

I'm very sorry but I can't give specific, personalized medical advice on here. I strongly recommend speaking with your doctor about symptoms or concerns.

[@SkeppGlocc]

Well it looks like I have cancer man. Varicies hurt so bad man. I’ve never been in so much pain in my damn life. I just don’t want to die. I’m only 20. 😖I’ve lost over 50lbs due to this shit.

[@SajalRanjanBhowmik]

What. Is. A. P. C

[@tuskartp6164]

i think im fallin in love with you Dr Strong

[@ashishnarwal7075]

👍

[@pavan351]

haa bawaa