title: Management of acute variceal bleeding.
abstract: Acute variceal bleeding (AVB) is the most common cause of upper gastrointestinal hemorrhage in patients with cirrhosis. Advances in the management of AVB have resulted in decreased mortality. To minimize mortality, a multidisciplinary approach addressing airway safety, prompt judicious volume resuscitation, vasoactive and antimicrobial pharmacotherapy, and early endoscopy to obliterate varices is necessary. Placement of a transjugular intrahepatic portosystemic shunt (TIPS) has been used as rescue therapy for patients failing initial attempts at hemostasis. Patients who have a high likelihood of failing initial attempts at hemostasis may benefit from a more aggressive approach using TIPS earlier in their management.
authors.affiliation: Division of Gastroenterology, University of South Alabama College of Medicine, Gastroenterology Academic Offices, 6000 University Commons, 75 University Boulevard S., Mobile, AL 36688-0002, USA. Electronic address: jherrera18@gmail.com.
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Herrera
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001803:Blood Transfusion; D002317:Cardiovascular Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D016099:Endoscopy, Gastrointestinal; D004932:Esophageal and Gastric Varices / Q000628:therapy*; D006801:Humans; D007442:Intubation, Intratracheal; D008026:Ligation; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents; D002317:Cardiovascular Agents
keywords: Acute variceal bleeding; Cirrhosis; Endoscopic band ligation; Endoscopy; Portal hypertension; Vasoactive therapy