Prevention of Esophageal Variceal Bleeding.
10.4166/kjg.2010.56.3.155
- Author:
Chang Hyeong LEE
1
Author Information
1. Department of Internal Medicine, Catholic University of Daegu College of Medicine, Daegu, Korea. chlee1@cu.ac.kr
- Publication Type:Review ; English Abstract
- Keywords:
Esophageal and gastric varices;
Prevention & control;
Non selective beta-blocker;
Ligation
- MeSH:
Adrenergic beta-Antagonists/therapeutic use;
Esophageal and Gastric Varices/drug therapy/*prevention & control;
Gastrointestinal Hemorrhage/*etiology;
Humans;
Ligation;
Portasystemic Shunt, Transjugular Intrahepatic;
Sclerotherapy
- From:The Korean Journal of Gastroenterology
2010;56(3):155-167
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Esophageal varices(EV) are present in 40% and 60% of Child-Pugh A and C patients, respectively when cirrhosis is diagnosed. EV bleeding is a life-threatening complication of liver cirrhosis with a high probability of recurrence. Treatment to prevent first EV bleeding or rebleeding is mandatory. In small EV with high risk of bleeding, nonselective beta-blockers should be used for the prevention of first variceal bleeding. For medium to large EV, nonselective beta-blockers or endoscopic variceal ligation (EVL) may be recommended to high risk varices. But, nonselective beta-blockers are the first treatment option to non-high risk varices and EVL is an alternative when nonselective beta-blockers are contraindicated or not tolerated. For the prevention of rebleeding, a combination of nonselective beta-blockers and EVL may be the best option. A great improvement in the prevention of variceal bleeding has emerged over the last years. However, further therapeutic options that combine higher efficacy, better tolerance and fewer side effects are needed.
