Abstract
Gastroesophageal variceal hemorrhage is a common complication of portal hypertension and a leading cause of death in patients with cirrhosis. The initial approach in a patient with suspected acute variceal bleeding consists of resuscitative measures with a restrictive transfusion strategy, prophylactic antibiotic therapy, and a vasoconstrictive agent, such as terlipressin or octreotide. Endoscopy is an integral part of the evaluation algorithm for suspected variceal hemorrhage. Combination vasopressive drug therapy and endotherapy in the form of endoscopic band ligation is the recommended treatment for acute esophageal variceal bleeding. Injection of tissue adhesives, namely, cyanoacrylate, is the preferred treatment modality for bleeding gastric varices. Transjugular intrahepatic portosystemic shunts or surgically created shunts are excellent salvage procedures. Survivors of variceal hemorrhage should be evaluated for liver transplantation.
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Sharma, K., Sarin, S.K. (2016). Approach to Suspected Variceal Bleeding. In: Wong Kee Song, L., Gorospe, E., Baron, T. (eds) GI Endoscopic Emergencies. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3085-2_4
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DOI: https://doi.org/10.1007/978-1-4939-3085-2_4
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