Portal hypertension and variceal hemorrhage.
Portal hypertension is a progressively debilitating complication of cirrhosis and a principal cause of mortality in patients who have hepatic decompensation. This article describes the classification system and pathophysiology of portal hypertension. It also discusses a practical approach to prevention of first variceal hemorrhage, general management of the acute bleeding episode, and secondary prophylaxis to prevent rebleeding. Pharmacologic, endoscopic, radiologic, and surgical modalities are all described in detail.
Sass
David A
DA
Division of Gastroenterology and Hepatology, Drexel University College of Medicine, 216 N. Broad Street, Feinstein Building, Suite 504, MS 1001, Philadelphia, PA 19102, USA. dsass@drexelmed.edu
Chopra
Kapil B
KB
D000465:Algorithms; D016099:Endoscopy, Gastrointestinal; D004932:Esophageal and Gastric Varices / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D006439:Hemodynamics; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D008103:Liver Cirrhosis / Q000150:complications; D015282:Octreotide / Q000627:therapeutic use; D011168:Portal System / Q000503:physiopathology; D011322:Primary Prevention; D055502:Secondary Prevention; D014662:Vasoconstrictor Agents / Q000008:administration & dosage; D014667:Vasopressins / Q000008:administration & dosage
D005765:Gastrointestinal Agents; D014662:Vasoconstrictor Agents; D014667:Vasopressins; D015282:Octreotide