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Editorial
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Volume 340:1033-1035 April 1, 1999 Number 13
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Primary Prevention of Bleeding from Esophageal Varices

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 by Sarin, S. K.
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Most patients with portal hypertension in North America and Europe have cirrhosis. Of those with compensated cirrhosis (i.e., cirrhosis with no ascites, encephalopathy, or severe jaundice), 30 percent have esophageal varices, as compared with 60 percent of those with decompensated cirrhosis.1 The risk of a first episode of bleeding from esophageal varices is higher among patients with cirrhosis who have severe liver dysfunction and those whose varices are large or have red signs — so-called varices on varices — identified endoscopically.2 Patients with cirrhosis may also have bleeding due to portal hypertensive gastropathy, nonvariceal mucosal abnormalities seen on endoscopy. These . . . [Full Text of this Article]

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