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- W2002104480 abstract "Variceal bleeding is one of the dreaded complications of portal hypertension. Patients who have suspected or proven cirrhosis should undergo diagnostic upper endoscopy to detect medium and large gastro-esophageal varices. Patients with medium and large gastro-esophageal varices should be treated with non-selective beta-blockers (propranolol or nadolol), and these agents should be titrated to a heart rate of 55 beats per minute or adverse effects. If there are contraindications to or if patients are intolerant to beta-blockers, it is appropriate to consider prophylactic banding therapy for individuals with medium-to-large esophageal varices. When patients who have cirrhosis present with GI bleeding, they should be resuscitated and receive octreotide or other vasoactive agents. Endoscopy should be performed promptly to diagnose the source of bleeding and to provide endoscopic therapy (preferably banding). The currently available treatment for acute variceal bleeding provides hemostasis in most patients. These patients, however, are at significant risk for rebleeding unless secondary prophylaxis is provided. Although various pharmacological, endoscopic, radiological, and surgical options are available, combined pharmacological and endoscopic therapy is the most common form of secondary prophylaxis. TIPS is a radiologically placed portasystemic shunt, and if placed in suitable patients, it can provide effective treatment for patients with variceal bleeding that is refractory to medical and endoscopic therapy." @default.
- W2002104480 created "2016-06-24" @default.
- W2002104480 creator A5023204216 @default.
- W2002104480 creator A5081039323 @default.
- W2002104480 date "2005-12-01" @default.
- W2002104480 modified "2023-09-27" @default.
- W2002104480 title "Bleeding Caused by Portal Hypertension" @default.
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- W2002104480 doi "https://doi.org/10.1016/j.gtc.2005.08.008" @default.
- W2002104480 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/16303574" @default.