Widened veins in the walls of the lower oesophagus and, sometimes, the upper part of the stomach.
Varices develop as a consequence of portal hypertension.
Blood in the portal vein, passing from the intestines to the liver, meets resistance due to liver disease.
The increased blood pressure causes blood to be diverted into small veins in the walls of the oesophagus and stomach.
These veins may become distended and rupture, causing vomiting of blood and black faeces.
There are usually other symptoms of chronic liver disease.
To control acute bleeding, a balloon catheter may be passed into the oesophagus to press on the bleeding varices.
The varices may be treated with an intravenous injection of vasopressin and/or by injection, via an endoscope, of a sclerosant that seals off the affected veins.
dilated veins in the lower oesophagus due to *portal hypertension. Varices have a high risk of bleeding, resulting in life-threatening *haematemesis. Bleeding may be arrested by band ligation (or banding): an endoscopic technique in which rubber bands are applied to the base of a bleeding varix. Injection of sclerosants into bleeding varices is an older technique not now widely used. Failure to stop variceal bleeding at endoscopy may require the insertion of a Sengstaken-Blakemore tube (a compression balloon). Nonendoscopic treatments for variceal bleeding include antibiotics and vasoactive agents (such as *terlipressin or octreotide).
A rare birth defect in which the oesophagus forms into 2 separate, blind-ended sections during development. There is usually an abnormal channel (tracheoesophageal fistula) between one of the sections and the trachea. The condition may be suspected before birth if the mother had polyhydramnios. The infant cannot swallow, and drools and regurgitates milk continually. If there is an upper tracheoesophageal fistula, milk may be sucked into the lungs, provoking attacks of coughing and cyanosis. Immediate surgery is needed to join the blind ends of the oesophagus and close the fistula. If the operation is successful, the baby should develop normally. Some babies, however, do not survive.... oesophageal atresia
A procedure to stretch the oesophagus when it has been narrowed by disease (see oesophageal stricture) and swallowing is difficult. Endoscopy is used to locate the obstruction. The narrowed area is then stretched by passing bougies (cylindrical rods with olive-shaped tips) down the oesophagus, or by using balloon catheters.... oesophageal dilatation
A sac-like protrusion of part of the oesophagus wall in which food becomes trapped, causing irritation, difficulty swallowing, halitosis, and regurgitation. A diverticulum is usually removed surgically.... oesophageal diverticulum
a disorder affecting the gullet (oesophagus) in which uncoordinated, sometimes simultaneous, oesophageal contractions precipitate difficulty in swallowing (*dysphagia), regurgitation of food, and chest pain. The cause is unclear. Diagnosis is suggested by characteristic appearances during a *barium swallow (corkscrew oesophagus) and confirmed by oesophageal manometry. Medical treatment comprises the use of calcium-channel blockers, nitrates, and sildenafil; endoscopic treatment may include infiltration of *botulinum toxin in specific oesophageal segments and, infrequently, endoscopic dilatation. Surgical myotomy is reserved for extreme cases.... diffuse oesophageal spasm
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