I had a gastroscopy about4 weeks ago and the report says that there is a hiatus hernia and some gastritis. No mention of varices.
I had a liver ultrasound two days before and the haematologist says that the scan confirms " hepatomegaly with cirrhotic changes as well as splenomegaly and varices"
I'm confused...surely varices would have been noted at the time of the gastroscopy and can varices be seen on a liver ultrasound?
Any advice would be very welcome.
Deb
I think i'd trust the endoscopy reporting no sign of varices rather than an ultrasound. My hubby has had ultrasounds that do mention the presence of varices but the only way to see them properly is endoscopy and as yours found none that's a good sign.
Katie
Hello Deb, I think this might depend on how far down the Endoscopy travelled. There are two main areas where a variceal bleed may occur, these are the oesophagus, and the hypertension portal vein.
If the examination was just checking for a possible hiatus hernia, the scope may have travelled down the oesophagus and into the stomach. The operator may not have been checking for varies withing the portal vein. I think a further examinations maybe advisable, only this time the scope should venture into the portal vein, (not very pleasant, I asked to knocked out completely, yes I'm a coward).
At least it would be a lot better to find them at this stage, rather than wait for one of them to bust as pressure within the vein builds up due to the cirrhosis blocking the blood supply.
I hope this helps.
Richard
Have you got a bit puddled with the terminology there Richard?
Portal Hypertension or high pressure in the portal vein is what causes varices to form elsewhere - when the blood pressure in the portal vein is too high i.e. blood can't get through the damaged liver, it causes a sort of back pressure where the blood backs up into smaller blood vessels which arn't meant to carry so much blood and this leads to them bulging into what they call varices and possibly bursting. I've certainly only heard of varices within the oesophagus, stomach and occasionally the bowel. My hubby has had 42 varices banded (all within the oesophagus) although his endoscopy always covers oesophagus, stomach and duodenum. He had one colonoscopy to check the rest of his bowel when he had anaemia.
His portal hypertension also lead to portal hypertesive gastropathy of his stomach lining and fundus plus numerous aneurysms in his splenic artery which required an embolisation operation to prevent a massive potentially life ending bleed. Occasionally early on his ultrasounds did indicate potential varices but they were only seen and treated via endoscopy.
Katie
This may seem a little weird as I understand what your saying. After I had my bleed, I had two endoscopy carried out. I was told that there wasn't any bleeding within the oesophagus and no signs of any varices. They did say that there was a lump within the stomach but as there was only one, they decided that this wasn't the cause and as it wasn't doing any harm they decided not touch it or take a biopsy. They did say they found them in the hepatic vein. I was kept in hospital for two days, no banding was required.
I think in general, that when the blood supply to the liver becomes compromised, it's as if a message is sent out to start producing an alternative route for the blood to be channelled. This is why they also often appear in the nose of all places. I used to get nose bleeds whenever blew my nose, which in hindsight could be a possible early warning for those who are about to have a variceal bleed.
Odd one but I guess that would be similar to hubbies splenic artery aneurysm.
Hello Katie my hubby nearly bled to death last August
I was reading your reply to bridesmaid he has checkups 6 monthly last month they found he had them in his stomach as well so the operation your husband had does this stop the bleeds thanks
My hubby had several aneurysms in his splenic artery which if it had burst would have almost certainly proved fatal. He had an embolisation operation whereby they entered through an artery in his groin and fed wires and mess up to block of the blood supply to his splenic artery - this did infact reduce his portal hypertension but also killed his spleen in the process. He had banding of the 42 oesophageal varices having presented first off with 7 bleeding ones.
Thankfully hubby has not so far presented with gastric varices though he does have changes to his stomach lining due to portal hypertensive gastropathy.
The only other operation I can think of that reduces portal hypertension and perhaps the risk of further bleeds is a TIPSS procedure (Transjugular Intrahepatic Portosystemic Shunt).
Hubby was having endoscopy and banding every 6-8 weeks at one point, now yearly checks. His varices were all dealt with until some 'barely visible' ones popped up in his latest test in June - still only due to go back June next year.
Katie
hi Richard you say you asked to be knocked out completely did they do it without a fuss ?
Yes, you get offered three options. The first one is a throat spray they use just to help the endoscope to slide down easier, and the numb the back of the throat. (I had this the very first time). The second option if I recall is to make you feel relaxed and a little drowsy. This helps your muscles from tensing up. The third option is to almost knock you out. You are still awake and can still feel the scope going down inside the stomach, it can also help stop gagging. You'll be lying on your left side when this procedure is carried out. It's not painful, but can be a little uncomfortable as the scope continues on it's travels.
Just be brave, the procedure should all be over in about 20 minutes. And then you can spend a further 20 minutes waiting for everything to ware and ease off.
I hope I haven't frightened you. This discomfort is a small price to pay as it could be said that all this is to make someone better.
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