Diagnosis and therapy of esophageal vascular disorders.
OBJECTIVE
The most relevant studies concerning the diagnosis of esophageal varices, primary and secondary prophylaxis and treatment of variceal bleeding published in the last year are reported.


RESULTS
The specific areas reviewed are those that refer to studies on the noninvasive or minimally invasive diagnosis of the presence of esophageal varices, the prevention of the formation and of the progression of varices from small to large, the prevention of the first variceal haemorrhage, the treatment of the acute bleeding episode, and the prevention of rebleeding.


CONCLUSIONS
Relevant studies are reviewed regarding the validation of noninvasive indices for the presence of varices, the use of the esophageal videocapsule to diagnose varices, the comparison of methods to prevent the first variceal haemorrhage, the use of the hepatic vein pressure measurement to monitor the haemodynamic response to beta-blockers, the long-term protection from bleeding by beta-blockers, the use of a double dose of somatostatin to control bleeding, the evaluation of the best endoscopic method to treat variceal bleeding in addition to vasoactive drugs, and the identification of prognostic factors for early and late mortality after a variceal bleed.
de Franchis
Roberto
R
Department of Medical Sciences, University of Milan, and Gastroenterology and Gastrointestinal Endoscopy Unit, Ospedale Policlinico, Mangiagalli and Regina Elena Foundation, Milan, Italy. roberto.defranchis@unimi.it
Dell'Era
Alessandra
A
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D053704:Capsule Endoscopy; D004932:Esophageal and Gastric Varices / Q000097:blood / Q000175:diagnosis* / Q000628:therapy*; D004945:Esophagoscopy; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D006801:Humans; D008026:Ligation; D010976:Platelet Count; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D013154:Spleen / Q000473:pathology; D015607:Stents; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D015415:Biomarkers; D014662:Vasoconstrictor Agents