title: [Mexican consensus on portal hypertension].
abstract: The aim of the Mexican Consensus on Portal Hypertension was to develop documented guidelines to facilitate clinical practice when dealing with key events of the patient presenting with portal hypertension and variceal bleeding. The panel of experts was made up of Mexican gastroenterologists, hepatologists, and endoscopists, all distinguished professionals. The document analyzes themes of interest in the following modules: preprimary and primary prophylaxis, acute variceal hemorrhage, and secondary prophylaxis. The management of variceal bleeding has improved considerably in recent years. Current information indicates that the general management of the cirrhotic patient presenting with variceal bleeding should be carried out by a multidisciplinary team, with such an approach playing a major role in the final outcome. The combination of drug and endoscopic therapies is recommended for initial management; vasoactive drugs should be started as soon as variceal bleeding is suspected and maintained for 5 days. After the patient is stabilized, urgent diagnostic endoscopy should be carried out by a qualified endoscopist, who then performs the corresponding endoscopic variceal treatment. Antibiotic prophylaxis should be regarded as an integral part of treatment, started upon hospital admittance and continued for 5 days. If there is treatment failure, rescue therapies should be carried out immediately, taking into account that interventional radiology therapies are very effective in controlling refractory variceal bleeding. These guidelines have been developed for the purpose of achieving greater clinical efficacy and are based on the best evidence of portal hypertension that is presently available.
authors.affiliation: Servicio de Gastroenterología, Departamento de Medicina Interna, Hospital Universitario «Dr. José Eleuterio González», Monterrey, N.L., México.
authors.forename: R M
authors.initials: RM
authors.lastname: Narváez-Rivera
authors.forename: C A
authors.initials: CA
authors.lastname: Cortez-Hernández
authors.forename: J A
authors.initials: JA
authors.lastname: González-González
authors.forename: J L
authors.initials: JL
authors.lastname: Tamayo-de la Cuesta
authors.forename: F
authors.initials: F
authors.lastname: Zamarripa-Dorsey
authors.forename: A
authors.initials: A
authors.lastname: Torre-Delgadillo
authors.forename: J F J
authors.initials: JF
authors.lastname: Rivera-Ramos
authors.forename: J I
authors.initials: JI
authors.lastname: Vinageras-Barroso
authors.forename: J E
authors.initials: JE
authors.lastname: Muneta-Kishigami
authors.forename: J M
authors.initials: JM
authors.lastname: Blancas-Valencia
authors.forename: M
authors.initials: M
authors.lastname: Antonio-Manrique
authors.forename: F
authors.initials: F
authors.lastname: Valdovinos-Andraca
authors.forename: P
authors.initials: P
authors.lastname: Brito-Lugo
authors.forename: A
authors.initials: A
authors.lastname: Hernández-Guerrero
authors.forename: R
authors.initials: R
authors.lastname: Bernal-Reyes
authors.forename: S
authors.initials: S
authors.lastname: Sobrino-Cossío
authors.forename: G R
authors.initials: GR
authors.lastname: Aceves-Tavares
authors.forename: H M
authors.initials: HM
authors.lastname: Huerta-Guerrero
authors.forename: N
authors.initials: N
authors.lastname: Moreno-Gómez
authors.forename: F J
authors.initials: FJ
authors.lastname: Bosques-Padilla
mesh_terms: D003663:Decision Trees; D004932:Esophageal and Gastric Varices / Q000209:etiology; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D008800:Mexico