This 60 year old woman came to the hospital emergency room one day after an unexpected episode of vomiting a cup of red blood. Blood tests revealed abnormal liver tests and some loss of blood. She had no knowledge of prior liver disease, but had a habit of drinking about a pint of vodka each day since she was widowed 9 years earlier. A gastroscopy exam revealed that the bleeding had come from swollen varicose veins in her esophagus. You can see these blue swollen veins in the picture above. These are called esophageal varices and are a sign of advanced liver disease. Often varices will rupture and hemorrhage as in this case - sometimes massively. Through the gastroscope, these swollen veins were clamped with tiny rubber bands and no further bleeding occured. She was advised to stop drinking and to return in 6 weeks for a followup visit. She did not keep her appointment and was not seen again.

Text & Images Courtesy of Three Rivers Endoscopy Center
© Dr. Robert Fusco, Three Rivers Endoscopy Center, All Rights Reserved