title: Gastroesophageal varices: pathogenesis and therapy of acute bleeding.
abstract: 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.
authors.affiliation: University of Colorado Health Sciences Center, Denver.
authors.forename: J S
authors.initials: JS
authors.lastname: Goff
mesh_terms: 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
chemical_list: D011108:Polymers; D001127:Arginine Vasopressin; D013004:Somatostatin