Name of the Condition

• Esophageal Varices with Bleeding
• ICD-10 Code: I85.01

Summary

Esophageal varices with bleeding refers to enlarged veins in the esophagus that have ruptured and are bleeding. This serious condition is often associated with liver disease and requires immediate medical attention.

Causes

• Liver cirrhosis, most commonly due to chronic alcohol consumption or hepatitis.
• Portal hypertension, which is increased blood pressure in the portal vein system.
• Blood vessel obstruction or thrombosis in the portal vein.

Risk Factors

• Chronic liver disease or cirrhosis.
• Excessive alcohol intake.
• Viral hepatitis (such as hepatitis B or C).
• Nonalcoholic fatty liver disease.

Symptoms

• Vomiting blood (hematemesis).
• Black, tarry stools (melena).
• Lightheadedness or dizziness.
• Signs of shock (low blood pressure, rapid pulse).

Diagnosis

• Endoscopy to visually confirm bleeding varices.
• Imaging tests like ultrasound or CT to assess liver and portal vein condition.
• Blood tests to evaluate liver function and clotting ability.

Treatment Options

• Endoscopic variceal ligation or sclerotherapy to stop the bleeding.
• Medications such as beta-blockers to reduce portal pressure.
• Transjugular intrahepatic portosystemic shunt (TIPS) to redirect blood flow.
• Liver transplant in severe cases of liver failure.

Prognosis and Follow-Up

• Prognosis depends on the severity of liver disease and response to treatment.
• Regular follow-ups are crucial to monitor liver health and prevent re-bleeding.
• Lifelong management may be necessary for chronic liver conditions.

Complications

• Hemorrhagic shock from severe blood loss.
• Recurrence of variceal bleeding.
• Worsening liver disease or complete liver failure.
• Increased risk of infections or kidney dysfunction.

Lifestyle & Prevention

• Abstain from alcohol to prevent liver damage.
• Maintain a healthy diet and weight to reduce liver strain.
• Regular medical check-ups for liver health if at risk.
• Manage chronic hepatitis infections effectively with appropriate treatment.

When to Seek Professional Help

• Immediate medical attention is needed for symptoms of bleeding, such as vomiting blood or passing black stools.
• Early intervention can prevent life-threatening complications.

Additional Resources

• American Liver Foundation: www.liverfoundation.org
• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): www.niddk.nih.gov
• Mayo Clinic Liver Disease Support Groups.

Tips for Medical Coders

• Ensure accurate recording of bleeding varices with I85.01 to differentiate from non-bleeding varices (I85.00).
• Review patient medical history for underlying liver conditions that might require additional coding.
• Avoid common errors like misclassifying bleeding varices as gastric varices or other gastrointestinal issues.