Management of portal hypertension after variceal hemorrhage.

V A Luketic

Journal: Clinics in liver disease 2002;5(3):677-707, ix

PMID: 11565137

Full Text on Elsevier Science View on PubMed

Abstract

Each variceal bleed is associated with 20% to 30% risk of dying. Management of portal hypertension after a bleed consists of (1) control of bleeding and (2) prevention of rebleeding. Effective control of bleeding can be achieved either pharmacologically by administering somatostatin or octreotide or endoscopically via sclerotherapy or variceal band ligation. In practice, both pharmacologic and endoscopic therapy are used concomitantly. Rebleeding can be prevented by endoscopic obliteration of varices. In this setting, variceal ligation is the preferred endoscopic modality. B-blockade is as effective as endoscopic therapy and, in combination, the two modalities may be additive.

Address: Division of Gastroenterology, Medical College of Virginia Commonwealth University, Richmond, Virginia, USA. [email protected]

DOI: 10.1016/s1089-3261(05)70188-4

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MeSH Terms: Adrenergic beta-Antagonists, Catheterization, Endoscopy, Hemodynamics, Hemorrhage, Humans, Hypertension, Portal, Ligation, Nitrates, Sclerotherapy, Varicose Veins, Vasodilator Agents