Acute variceal hemorrhage.
Variceal bleeding is a frequent and life-threatening complication of portal hypertension. The first episode of variceal bleeding is associated not only with a high mortality, but also with a high recurrence rate in those who survive. Therefore, management should focus on different therapeutic strategies aiming to prevent the first episode of variceal bleeding (primary prophylaxis), to control hemorrhage during the acute bleeding episode (emergency treatment), and to prevent rebleeding (secondary prophylaxis). These strategies involve pharmacological, endoscopic, surgical, and interventional radiological modalities. This article reviews management of acute variceal bleeding.
Habib
Adil
A
Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University Medical Center, MCV Box 980341, Richmond, VA 23298-0341, USA.
Sanyal
Arun J
AJ
D000208:Acute Disease; D004630:Emergencies; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D008026:Ligation; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D015911:Sclerotherapy / Q000379:methods