Variceal bleeding: Current issues

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Current endoscopic therapy of variceal bleeding.

Variceal ligation has proved more effective and safer than sclerotherapy and is currently the endoscopic treatment of choice for oesophageal varices. In acute bleeding, vasoactive drugs should be started before endoscopy and maintained for 2-5 days. The efficacy of drugs is improved when associated with emergency endoscopic therapy. Antibiotic prophylaxis should also be used. To prevent rebleed...

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Variceal bleeding

Approximately 90% of patients with cirrhosis will have developed gastro-oesophageal varices within 10 yr. Oesophageal variceal haemorrhage is a devastating complication of cirrhosis with mortality as high as 25–50%. Therefore, prophylactic measures before the first bleed are crucial. If patients survive a variceal bleed, there is approximately a 70% risk that they will have a further bleed with...

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Background and Methods: We compared propranolol therapy and endoscopic ligation for the primary prevention of bleeding from esophageal varices.

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Variceal bleeding: pharmacological therapy.

The complications of portal hypertension are totally prevented if hepatic venous pressure gradient is decreased below 12 mm Hg. Besides, if this target is not achieved, a 20% decrease in portal pressure from baseline levels offers an almost total protection from variceal bleeding. This sets the rationale for drug therapy to reduce portal pressure in portal hypertension. Pharmacological therapy ...

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Octreotide in variceal bleeding.

Bleeding from oesophageal varices has a high death rate. Injection sclerotherapy is the most appropriate treatment but facilities for this are not always available. Balloon tamponade and vasoactive therapy may be used as stop gap measures. Somatostatin and octreotide are therapeutic candidates for the treatment of variceal bleeding and there are several trials that have compared somatostatin an...

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ژورنال

عنوان ژورنال: Saudi Journal of Medicine and Medical Sciences

سال: 2014

ISSN: 1658-631X

DOI: 10.4103/1658-631x.128397