Endoscopic Management of Variceal Haemorrhage

Alessandra Dell’Era, Francesca Iannuzzi, Roberto de Franchis

Abstract


One of the most important complications of portal hypertension, in the setting of liver cirrhosis or of non-cirrhotic portal hypertension, is upper gastrointestinal bleeding from ruptured gastroesophageal varices and portal hypertensive gastropathy. The management of the acute variceal bleeding is a multidisciplinary process that includes the initial assessment of the patient, effective resuscitation, timely diagnosis, control of bleeding and prevention of early rebleeding and complications such as infection, hepatorenal syndrome, or hepatic encephalopathy. Antibiotic prophylaxis, conservative targets for blood transfusions and combination therapy with vasoactive drugs and endoscopic treatments are the first-line measures in the management of acute variceal bleeding; transjugular intrahepatic portosystemic shunts should be proposed early to high-risk patients or as a rescue therapy for those who fail first-line treatment.

Keywords


Esophageal varices; Gastric varices; Ectopic varices; Acute variceal bleeding; Endoscopic variceal ligation; Endoscopic sclerotherapy; Antibiotic prophylaxis; Vasoactive drugs; TIPS

Full Text: PDF HTML

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.