Esophageal Varices & Variceal Hemorrhage Treatment and Managment(STEP WISE APPROACH)

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MedNerd - Dr. Waqas Fazal

MedNerd - Dr. Waqas Fazal

4 жыл бұрын

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.
.
• 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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Пікірлер: 98
@MedNerdDrWaqasFazal
@MedNerdDrWaqasFazal Жыл бұрын
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. DON'T FORGET TO CLICK ON SUBSCRIBE BUTTON 😊 FOLLOW ME ON Instagram: instagram.com/docwaqasfazal/ Facebook: facebook.com/Drwaqasfazal
@zohrafarooq5782
@zohrafarooq5782 Жыл бұрын
Sir what about Transexamic acid???
@syedamaryambanogilani6996
@syedamaryambanogilani6996 8 ай бұрын
why i didnt find your channel at start of my final year!!!! .....best lectures.....
@farhanabashir4524
@farhanabashir4524 3 жыл бұрын
Came here from Armando hasadagun’s channel....your vedios and way of explaining things are simply amazing sir...you actually got a subscriber!
@MedNerdDrWaqasFazal
@MedNerdDrWaqasFazal 3 жыл бұрын
Thank you very much Farhana! I am really glad that you liked it. 🙂
@samik3184
@samik3184 Жыл бұрын
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!
@dr.usmanawan3596
@dr.usmanawan3596 4 жыл бұрын
This flow chart has made such lengthy topic so easy.
@MedNerdDrWaqasFazal
@MedNerdDrWaqasFazal 3 жыл бұрын
Thank you Dr usman 😊
@TheWahabfazal53
@TheWahabfazal53 4 жыл бұрын
What an excellent way of teaching Medicine !
@MedNerdDrWaqasFazal
@MedNerdDrWaqasFazal 3 жыл бұрын
Thank you wahab! ❤️
@mtmadv7872
@mtmadv7872 2 жыл бұрын
Wow ,,,, a difficult topic made so easy and conceptual.... thnx a lot sir
@mahnoorfatima8499
@mahnoorfatima8499 3 ай бұрын
Best channel to learn management of diseases so far👏
@Sgtnathenhale
@Sgtnathenhale 4 жыл бұрын
Very good revision Keeps me on my toes and highlights my errors
@MedNerdDrWaqasFazal
@MedNerdDrWaqasFazal 3 жыл бұрын
Thank you Kamal! ❤️
@gracewaithaka9382
@gracewaithaka9382 2 жыл бұрын
Excellent explanation! Thank you.
@AbhikAbhi09
@AbhikAbhi09 2 жыл бұрын
The Way of explaining❤really loved it!!!
@MedNerdDrWaqasFazal
@MedNerdDrWaqasFazal 2 жыл бұрын
Thank you Abhijit. 😊
@medicoinrus2088
@medicoinrus2088 2 жыл бұрын
Beautifully explain management 🌟
@nur_mohamud
@nur_mohamud Жыл бұрын
Excellent and consice concept, thank you sir.
@debigdogk9563
@debigdogk9563 Жыл бұрын
Well done doc. Your are one of the best. This is an excellent teaching. Thank you.❤❤❤❤❤❤❤
@MedNerdDrWaqasFazal
@MedNerdDrWaqasFazal Жыл бұрын
So kind of you. I read all of your comments. I am very happy that you found my videos helpful. Keep supporting 😊
@camrank3334
@camrank3334 2 жыл бұрын
Explained very well 💯
@ranjithgonzalez653
@ranjithgonzalez653 6 ай бұрын
Great sir, your videos are amazing and to the point
@marianauroz9845
@marianauroz9845 Жыл бұрын
excellent concept!
@anjum.mehmood3730
@anjum.mehmood3730 3 ай бұрын
Simple yet excellent ❤
@anonymous-td2wy
@anonymous-td2wy 2 жыл бұрын
Beautiful lecture 💗💗
@docdays2010
@docdays2010 2 жыл бұрын
Outstanding lecture 👌🇮🇳
@seemakhanna4209
@seemakhanna4209 2 жыл бұрын
Very nice explaination!!!
@drarjungupta2458
@drarjungupta2458 3 жыл бұрын
Very nicely described...
@happyvalleyroses8145
@happyvalleyroses8145 2 жыл бұрын
Too good!!
@sukalyanpanja1558
@sukalyanpanja1558 5 ай бұрын
Sir am 1st saw your ecg video....then i follow only your channel in medicine
@shadabanwar3293
@shadabanwar3293 Жыл бұрын
Awesome 👍
@haniehrastgou4784
@haniehrastgou4784 6 ай бұрын
Perfect,thank you
@susmithamarella1514
@susmithamarella1514 11 ай бұрын
Nice explanation..thank you ❤
@srinivasaraosirasapalli5104
@srinivasaraosirasapalli5104 2 жыл бұрын
Excellent sir
@jiolife9358
@jiolife9358 2 жыл бұрын
Thank you sir!
@asadmasood6692
@asadmasood6692 2 жыл бұрын
Great sir
@neerusain56
@neerusain56 Жыл бұрын
Excellent
@DR_HARIS_KHAN
@DR_HARIS_KHAN 4 жыл бұрын
Mash Allah ❤️
@Chorizo1
@Chorizo1 2 жыл бұрын
This was very impressive and easy to follow.
@thaniorumanithaninmaatram3079
@thaniorumanithaninmaatram3079 Жыл бұрын
It's true only
@user-ww9rt8sl3f
@user-ww9rt8sl3f 10 күн бұрын
Amazing 🤩
@simonnginyamoi4967
@simonnginyamoi4967 Жыл бұрын
Wonderful presentation, for how long will the patient with TIPS receive Lactulose?
@warisahmed3043
@warisahmed3043 4 жыл бұрын
You made it so simple and easy
@MedNerdDrWaqasFazal
@MedNerdDrWaqasFazal 3 жыл бұрын
Thank you waris!
@DrBikram
@DrBikram Жыл бұрын
Sir Almost done ✅..i have seen most ...only few remain...if possible please do hematology part.
@thaniorumanithaninmaatram3079
@thaniorumanithaninmaatram3079 Жыл бұрын
Very nice
@celebebuzzstalker2938
@celebebuzzstalker2938 3 жыл бұрын
very good explanation ...help me to understand it...thanks man
@MedNerdDrWaqasFazal
@MedNerdDrWaqasFazal 3 жыл бұрын
Thank you. I am glad it helped you. 😊
@alshelwi2010
@alshelwi2010 3 жыл бұрын
Nice
@rosemariya5351
@rosemariya5351 Жыл бұрын
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
@furqanulhaq1782
@furqanulhaq1782 3 жыл бұрын
explained very well sir, great job
@MedNerdDrWaqasFazal
@MedNerdDrWaqasFazal 3 жыл бұрын
Thank you furqan ❤️
@rameshkumawat63
@rameshkumawat63 3 жыл бұрын
Excellent💯👍 describe sir ji
@MedNerdDrWaqasFazal
@MedNerdDrWaqasFazal 3 жыл бұрын
Thank you Ramesh Kumawat :)
@user-em3jf8mi6c
@user-em3jf8mi6c 3 ай бұрын
Thank u
@cristinasanny8504
@cristinasanny8504 3 жыл бұрын
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!!!
@MedNerdDrWaqasFazal
@MedNerdDrWaqasFazal 3 жыл бұрын
Thank you very much Varshu Pandey... I am glad you found it helpful 🙂
@fahadfarooq1391
@fahadfarooq1391 4 жыл бұрын
Plz make videos on respiratory system.
@drqasimafridi3652
@drqasimafridi3652 4 жыл бұрын
Explained well💓
@MedNerdDrWaqasFazal
@MedNerdDrWaqasFazal 3 жыл бұрын
Thank you Dr Qasim!
@rakeshshaw2724
@rakeshshaw2724 Жыл бұрын
Sir ur videos are very informative and easy to understand. Pls make a video on peptic ulcer,thank you .
@MedNerdDrWaqasFazal
@MedNerdDrWaqasFazal Жыл бұрын
Sure I will. thank you :)
@subhashgrover3087
@subhashgrover3087 Жыл бұрын
Sir you are excellent teacher
@MedNerdDrWaqasFazal
@MedNerdDrWaqasFazal Жыл бұрын
Thank you 😊
@katyclayton
@katyclayton 2 жыл бұрын
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.
@drsaadmanan6808
@drsaadmanan6808 4 жыл бұрын
Great work MA ♥️
@MedNerdDrWaqasFazal
@MedNerdDrWaqasFazal 3 жыл бұрын
Thank you Saad ❤️
@saugatasantra6774
@saugatasantra6774 2 жыл бұрын
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?
@shayanazizkhattak5776
@shayanazizkhattak5776 4 жыл бұрын
Good explanation!
@MedNerdDrWaqasFazal
@MedNerdDrWaqasFazal 3 жыл бұрын
Thank you Shayan! 😊
@AethicGlassworks
@AethicGlassworks 3 жыл бұрын
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?
@MedNerdDrWaqasFazal
@MedNerdDrWaqasFazal 3 жыл бұрын
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.
@AethicGlassworks
@AethicGlassworks 3 жыл бұрын
@@MedNerdDrWaqasFazal dang, sounds like a brutal way to go. Thanks for the explanation again! Keep up the awesome work! These are very informative!
@anjum.mehmood3730
@anjum.mehmood3730 3 ай бұрын
Dr sb are their ways people could have known about these varicose before developing
@mehranlaghari118
@mehranlaghari118 2 жыл бұрын
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
@gopalmaity63
@gopalmaity63 9 ай бұрын
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?
@drasadmasood572
@drasadmasood572 Жыл бұрын
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
@MedNerdDrWaqasFazal
@MedNerdDrWaqasFazal Жыл бұрын
Sure I will upload another video in more detail. 😊
@chandrakantyadav514
@chandrakantyadav514 2 жыл бұрын
AFTRR doing all these procedures how will be the prognosis 0f patient
@zohrafarooq5782
@zohrafarooq5782 Жыл бұрын
What is the dose of octreotide and total duration??
@kayraydv0504
@kayraydv0504 7 ай бұрын
What to do when bleeding is not stopping then how to do endscopy
@anonymous-td2wy
@anonymous-td2wy 2 жыл бұрын
Do we do band ligation only when the pt is hemodynamically stabilized? I’m a new nurse sorry if its a silly question.
@MedNerdDrWaqasFazal
@MedNerdDrWaqasFazal 2 жыл бұрын
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.
@anonymous-td2wy
@anonymous-td2wy 2 жыл бұрын
@@MedNerdDrWaqasFazal thank you
@subbaramasubbarama3360
@subbaramasubbarama3360 2 жыл бұрын
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
@xcvgamerxyy9685
@xcvgamerxyy9685 4 ай бұрын
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
@maazali7724
@maazali7724 2 ай бұрын
Can we go for transplant at this stage?
@tajnurparvin1308
@tajnurparvin1308 3 жыл бұрын
Sir,this problem is seen of father in law.How can we contact with you?
@zohrafarooq5782
@zohrafarooq5782 Жыл бұрын
What about Transexamic acid in acute Mx???
@studypro1582
@studypro1582 4 ай бұрын
Sir, My mother has been detected with Esophagus variaces Grade-3. How serious is the disease doctor. Please respond🙏🙏
@abdullah6863
@abdullah6863 Ай бұрын
🎉
@PAWANKumar-nz5jq
@PAWANKumar-nz5jq 2 жыл бұрын
Sir what is PARTO?
@haniehrastgou4784
@haniehrastgou4784 6 ай бұрын
and dosage of octreotide is 50mirogram bolus then 50micro per hour ifusion
@samarmemon9546
@samarmemon9546 Жыл бұрын
Amazing teacher but very fast
@abhayabehera2685
@abhayabehera2685 Жыл бұрын
Sir My mother is suffer hypertension...
@samarmemon9546
@samarmemon9546 Жыл бұрын
No full stop . Highly difficult to take notes
@mayaryar123
@mayaryar123 Жыл бұрын
Don't waste ur time , there is no permanent treatment in medical for esophagus varies only homeopathic is best way to treat
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