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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...

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Detalles Bibliográficos
Autores principales: Li, Yan, Zhang, Chun Qing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2009
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.
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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
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