Gastroesophageal variceal hemorrhage, a major complication ofportal hypertension resulting from cirrhosis, accounts for 10to 30 percent of all cases of bleeding from the upper gastrointestinaltract.1 Variceal hemorrhage occurs in 25 to 35 percent of patientswith cirrhosis and accounts for 80 to 90 percent of bleedingepisodes in these patients.2,3,4 Variceal hemorrhage is associatedwith more substantial morbidity and mortality than other causesof gastrointestinal bleeding, as well as with higher hospitalcosts.5,6,7 Up to 30 percent of initial bleeding episodes arefatal, and as many as 70 percent of survivors have recurrentbleeding after a first . . . [Full Text of this Article]
Pathogenesis of Gastroesophageal Varices
Prediction of Variceal Hemorrhage
Primary Prevention of Bleeding from Esophageal Varices
Pharmacologic Therapy
Endoscopic Therapy
Management of Acute Variceal Hemorrhage
Pharmacologic Therapy
Endoscopic Therapy
Balloon Tamponade
Transjugular Intrahepatic Portosystemic Shunt
Surgical Therapy
Prevention of Recurrent Variceal Bleeding
Pharmacologic Therapy
Endoscopic Therapy
Transjugular Intrahepatic Portosystemic Shunt
Surgical Therapy
Cost Effectiveness of Available Therapies
Conclusions
Source Information
From the Division of Gastroenterology, Department of Medicine, American University of Beirut Medical Center, Beirut, Lebanon (A.I.S.); and the Division of Gastroenterology, Department of Medicine, and the Duke Liver Center, Duke University Medical Center, Durham, N.C. (A.I.S., D.C.R.).
Address reprint requests to Dr. Rockey at the Duke Liver Center, DUMC Box 3083, Duke University Medical Center, Durham, NC 27710, or at dcrockey@acpub.duke.edu.
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