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Management of Variceal Hemorrhage
Variceal hemorrhage is a frequent and lethal complication of portal hypertension. Bleeding occurs in 30%-40% of patients with cirrhosis and varices. The first episode of variceal bleeding is associated with a high mortality as well as a high incidence of re-bleeding. Thus, management of variceal hem...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elmer Press
2009
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139880/ https://www.ncbi.nlm.nih.gov/pubmed/27956945 http://dx.doi.org/10.4021/gr2009.02.1275 |
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author | Li, Yan Zhang, Chun Qing |
author_facet | Li, Yan Zhang, Chun Qing |
author_sort | Li, Yan |
collection | PubMed |
description | Variceal hemorrhage is a frequent and lethal complication of portal hypertension. Bleeding occurs in 30%-40% of patients with cirrhosis and varices. The first episode of variceal bleeding is associated with a high mortality as well as a high incidence of re-bleeding. Thus, management of variceal hemorrhage should be categorized into 3 phases: primary prophylaxis (prevention of the first episode of bleeding), emergency treatment (management of acute bleeding), and secondary prophylaxis (prevention of re-bleeding). Modalities involved include pharmacological, endoscopic, surgical, interventional radiological therapy and balloon tamponade. This review summarizes the current choices of management during each phase, and concentrates on the following questions, what can we do to prevent the formation and development of varices; how can we predicate the risk of bleeding; what should we do in case of bleeding; what is the first-line therapy; what should we do when current therapy fails; when should we give up and what is the optimal strategy for secondary prophylaxis. |
format | Online Article Text |
id | pubmed-5139880 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2009 |
publisher | Elmer Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-51398802016-12-12 Management of Variceal Hemorrhage Li, Yan Zhang, Chun Qing Gastroenterology Res Review Variceal hemorrhage is a frequent and lethal complication of portal hypertension. Bleeding occurs in 30%-40% of patients with cirrhosis and varices. The first episode of variceal bleeding is associated with a high mortality as well as a high incidence of re-bleeding. Thus, management of variceal hemorrhage should be categorized into 3 phases: primary prophylaxis (prevention of the first episode of bleeding), emergency treatment (management of acute bleeding), and secondary prophylaxis (prevention of re-bleeding). Modalities involved include pharmacological, endoscopic, surgical, interventional radiological therapy and balloon tamponade. This review summarizes the current choices of management during each phase, and concentrates on the following questions, what can we do to prevent the formation and development of varices; how can we predicate the risk of bleeding; what should we do in case of bleeding; what is the first-line therapy; what should we do when current therapy fails; when should we give up and what is the optimal strategy for secondary prophylaxis. Elmer Press 2009-02 2009-01-20 /pmc/articles/PMC5139880/ /pubmed/27956945 http://dx.doi.org/10.4021/gr2009.02.1275 Text en Copyright 2009, Li et al. http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Li, Yan Zhang, Chun Qing Management of Variceal Hemorrhage |
title | Management of Variceal Hemorrhage |
title_full | Management of Variceal Hemorrhage |
title_fullStr | Management of Variceal Hemorrhage |
title_full_unstemmed | Management of Variceal Hemorrhage |
title_short | Management of Variceal Hemorrhage |
title_sort | management of variceal hemorrhage |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139880/ https://www.ncbi.nlm.nih.gov/pubmed/27956945 http://dx.doi.org/10.4021/gr2009.02.1275 |
work_keys_str_mv | AT liyan managementofvaricealhemorrhage AT zhangchunqing managementofvaricealhemorrhage |