title: Epidemiology, diagnosis and early patient management of esophagogastric hemorrhage.
abstract: Acute variceal bleeding (AVB) is a potentially life-threatening complication of cirrhosis and portal hypertension. Combination therapy with vasoactive drugs and endoscopic variceal ligation is the first-line treatment in the management of AVB after adequate hemodynamic resuscitation. Short-term antibiotic prophylaxis, early resuscitation, early use of lactulose for prevention of hepatic encephalopathy, targeting of conservative goals for blood transfusion, and application of early transjugular intrahepatic portosystemic shunts in patients with AVB have further improved the prognosis of AVB. This article discusses the epidemiology, diagnosis, and nonendoscopic management of AVB.
authors.affiliation: Department of Internal Medicine, Abington Memorial Hospital, 1200 Old York Road, Abington, PA 19001, USA.
authors.forename: Sumit
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Baylor University Medical Center, 3410 Worth Street, Suite 860, Dallas, TX 75246, USA.
authors.forename: Sumeet K
authors.initials: SK
authors.lastname: Asrani
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street Southwest, Rochester, MN 55905, USA. Electronic address: kamath.patrick@mayo.edu.
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Kamath
mesh_terms: D000208:Acute Disease; D058109:Airway Management; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D021721:Balloon Occlusion; D001803:Blood Transfusion; D054459:Elasticity Imaging Techniques; D016099:Endoscopy, Gastrointestinal; D004932:Esophageal and Gastric Varices / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000000981:diagnostic imaging; D008954:Models, Biological; D017082:Portal Pressure; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D015607:Stents; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D014662:Vasoconstrictor Agents
keywords: Acute variceal bleeding; Endoscopic variceal ligation; Esophageal varices; Gastric varices