Management of acute variceal bleeding.
Portal hypertension as a consequence of liver cirrhosis is responsible for its most common complications: ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, hepatic encephalopathy and the most important one--variceal hemorrhage. Variceal bleeding results in considerable morbidity and mortality. This review covers all areas of importance in the therapy of acute variceal hemorrhage--endoscopic and pharmacological treatment, transjugular intrahepatic portosystemic shunt, surgery and balloon tamponade. Indications and limitations of these therapeutic modalities are widely discussed.
Lata
Jan
J
Department of Internal Medicine and Gastroentrology, Faculty of Medicine, Masaryk University, Brno, Czech Republic. jlata@fnbrno.cz
Hulek
Petr
P
Vanasek
Tomas
T
D000208:Acute Disease; D000465:Algorithms; D021721:Balloon Occlusion; D002404:Catheterization; D016145:Endoscopy, Digestive System; D004932:Esophageal and Gastric Varices / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D006439:Hemodynamics; D016558:Hemostasis, Endoscopic; D006801:Humans; D016031:Liver Transplantation; D008236:Lypressin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015282:Octreotide / Q000627:therapeutic use; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D015911:Sclerotherapy; D013004:Somatostatin / Q000627:therapeutic use; D000077585:Terlipressin; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
D014662:Vasoconstrictor Agents; D008236:Lypressin; D013004:Somatostatin; D000077585:Terlipressin; D015282:Octreotide