Gastroesophageal varices: pathogenesis and therapy of acute bleeding.
Numerous conditions lead to portal hypertension and the development of esophageal or gastric varices, or both. Treatment of patients with acute bleeding should progress in a logical, stepwise fashion. Initial therapy includes vasopressin, somatostatin, or balloon tamponade with a Sengstaken-Blakemore tube. The next step is treatment with sclerotherapy, variceal ligation, or a combination of both. Continued bleeding is managed by more invasive measures, which may include radiologic embolization or shunting, esophageal transection, distal splenorenal shunt, or liver transplantation.
Goff
J S
JS
University of Colorado Health Sciences Center, Denver.
D000208:Acute Disease; D001127:Arginine Vasopressin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004932:Esophageal and Gastric Varices / Q000150:complications*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000628:therapy*; D016558:Hemostasis, Endoscopic; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology; D007267:Injections; D007441:Intubation, Gastrointestinal / Q000379:methods; D008026:Ligation; D011108:Polymers / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D015911:Sclerotherapy; D013004:Somatostatin / Q000627:therapeutic use; D013514:Surgical Procedures, Operative / Q000379:methods
D011108:Polymers; D001127:Arginine Vasopressin; D013004:Somatostatin