Endoscopic Management of Portal Hypertension

Endoscopic Management of Portal Hypertension

Cirrhosis is the leading cause of portal hypertension worldwide, with the development of bleeding gastroesophageal varices being one of the most life-threatening consequences. Endoscopy plays an indispensible role in the diagnosis, staging, and prophylactic or active management of varices. With the expected future refinements in endoscopic technology, capsule endoscopy may one day replace tradi...

Endoscopic Ultrasonography In Portal Hypertension

Endoscopic ultrasonography (EUS) has recently emerged as an alternative means of providing data for patients with portal hypertension that is more accurate, less invasive and reproducible. It is well established that video-echo endoscopy, with combined endoscopic and sonographic examination, is comparable to endoscopy in diagnosing esophageal varices, but is more sensitive in diagnosing the pre...

Management of portal hypertension.

Management of portal hypertension.

Complications of portal hypertension are the leading cause of death in patients with liver cirrhosis. Rational medical and endoscopic therapy is guided by a thorough understanding of the underlying pathophysiology of ascites, variceal formation and bleeding, hepatorenal syndrome, and hepatic encephalopathy. The pathophysiology of each clinical entity is reviewed followed by an evidence-based di...

Management of portal hypertension.

Treatment of portal hypertension is evolving based on randomised controlled trials. In acute variceal bleeding, prophylactic antibiotics are mandatory, reducing mortality as well as preventing infections. Terlipressin or somatostatin combined with endoscopic ligation or sclerotherapy is the best strategy for control of bleeding but there is no added effect of vasoactive drugs on mortality. Non-...