title: Pregnancy and cirrhosis: management of hematemesis by Warren shunt during third trimester gestation.
abstract: Considerable pathophysiologic changes accompany cirrhosis. Elevation of portal venous pressure predisposes to esophageal varices and hematemesis. The physiologic changes associated with pregnancy may exacerbate these conditions. Medical management of cirrhosis-associated problems may fail, necessitating surgical intervention. The anesthetic management of a pregnant cirrhotic patient for a Warren shunt is complicated by concerns for pre-existing hepatic dysfunction and pregnancy-induced physiologic changes as well as fetal well-being. The management of such a case is reviewed and relevant pathophysiology discussed.
authors.affiliation: Department of Anesthesiology, University of Colorado Health Sciences Center, Campus Box B113, 4200 East Ninth Avenue, Denver, Colorado 80262, USA.
authors.forename: J
authors.initials: J
authors.lastname: Duke