title: Prevention of recurrent haemorrhage.
abstract: Patients who survive a first bleeding episode of oesophageal varices have a high risk of rebleeding, which is associated with a high mortality rate. Prevention of a recurrent haemorrhage is therefore recommended. Patients who were not on a primary prophylaxis should be treated with non-selective beta-adrenoceptor antagonists, endoscopic band ligation or both. If beta-blockers are not tolerated or are contraindicated, patients should be treated with endoscopic band ligation. If these preventive strategies fail, transjugular intrahepatic portosystemic shunt (covered) or a small-diameter surgical shunt is indicated.
authors.affiliation: Department of Internal Medicine I, University of Bonn, Sigmund-Freud Strasse 25, D-53105 Bonn, Germany. joerg.heller@ukb.uni-bonn.de
authors.forename: Jörg
authors.initials: J
authors.lastname: Heller
authors.forename: Tilman
authors.initials: T
authors.lastname: Sauerbruch
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000175:diagnosis*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D016558:Hemostasis, Endoscopic; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000175:diagnosis*; D015911:Sclerotherapy / Q000379:methods; D055502:Secondary Prevention; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D000319:Adrenergic beta-Antagonists; D014665:Vasodilator Agents