Current approaches to the management of patients with liver cirrhosis who have acute esophageal variceal bleeding

Current Medical Research and Opinion
Dmitry Victorovich Garbuzenko

Abstract

Esophageal variceal bleeding is the most dangerous complication in patients with liver cirrhosis, and it is accompanied by high mortality. Their treatment can be complex, and requires a multidisciplinary approach. This review examines current approaches to the management of patients with liver cirrhosis who have acute esophageal variceal bleeding. PubMed, Google Scholar, and Cochrane Systematic Reviews were searched for articles published between 1987 and 2015. Relevant articles were identified using the following terms: 'esophageal variceal bleeding', 'portal hypertension' and 'complications of liver cirrhosis'. The reference lists of articles identified were also searched for other relevant publications. Inclusion criteria were restricted to the management of patients with liver cirrhosis who have acute esophageal variceal bleeding. It is currently recommended to combine vasoactive drugs (preferable somatostatin or terlipressin) and endoscopic therapies (endoscopic band ligation as first choice, sclerotherapy if endoscopic band ligation not feasible) for the initial treatment of acute variceal bleeding. Antibiotic prophylaxis must be regarded as an integral part of the treatment. The use of a Sengstaken-Blakemore tube is appr...Continue Reading

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Citations

Dec 14, 2017·The Korean Journal of Internal Medicine·Su Sun KimWoon Geon Shin
Sep 11, 2018·World Journal of Gastroenterology : WJG·Dmitry Victorovich GarbuzenkoEvgeniy Leonidovich Kazachkov

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