Endoscopic treatments for portal hypertension

Acute esophageal variceal hemorrhage is a dreaded complication of portal hypertension. Its management has evolved rapidly in recent years. Endoscopic therapy is often employed to arrest bleeding varices as well as to prevent early rebleeding. The combination of vasoconstrictor and endoscopic therapy...

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Bibliographic Details
Published in:Hepatology international 2018-02, Vol.12 (Suppl 1), p.91-101
Main Author: Lo, Gin-Ho
Format: Article
Language:English
Subjects:
Adrenergic beta-Antagonists - therapeutic use
Balloon Occlusion - methods
Banding
Bleeding
Catastrophic events
Colorectal Surgery
Combined Modality Therapy - methods
Cyanoacrylates - therapeutic use
Endoscopy
Endoscopy - methods
Esophageal and Gastric Varices - complications
Esophageal and Gastric Varices - pathology
Esophageal and Gastric Varices - therapy
Esophagus
Gastrointestinal Hemorrhage - etiology
Gastrointestinal Hemorrhage - prevention & control
Gastrointestinal Hemorrhage - therapy
Hemorrhage
Hepatology
Humans
Hypertension
Hypertension, Portal - complications
Hypertension, Portal - therapy
Ligation - methods
Medicine
Medicine & Public Health
Prophylaxis
Sclerotherapy
Sclerotherapy - methods
Special Issue - Portal Hypertension
Surgery
Therapy
Vasoconstrictor Agents - therapeutic use
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Summary:Acute esophageal variceal hemorrhage is a dreaded complication of portal hypertension. Its management has evolved rapidly in recent years. Endoscopic therapy is often employed to arrest bleeding varices as well as to prevent early rebleeding. The combination of vasoconstrictor and endoscopic therapy is superior to vasoconstrictor or endoscopic therapy alone for control of acute esophageal variceal hemorrhage. After control of acute variceal bleeding, combination of banding ligation and beta-blockers is generally recommended to prevent variceal rebleeding. To prevent the catastrophic event of acute variceal bleeding, endoscopic banding ligation is an important tool in the prophylaxis of first bleeding. Endoscopic obturation with cyanoacrylate is usually utilized to arrest acute gastric variceal hemorrhage as well as to prevent rebleeding. It can be concluded that endoscopic therapies play a pivotal role in management of portal hypertensive bleeding.
ISSN:1936-0533
1936-0541
DOI:10.1007/s12072-017-9828-8