Management of Acute Esophageal Variceal Hemorrhage
Acute esophageal variceal hemorrhage (AEVH) is a severe complication of portal hypertension. Its management has rapidly evolved in recent years. Traditional methods included vasoconstrictor and balloon tamponade. Vasoconstrictors were shown to control approximately 80% of the bleeding episodes and a...
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| Format: | Article |
| Language: | English |
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Wiley
2010-02-01
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| Series: | Kaohsiung Journal of Medical Sciences |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1607551X10700097 |
| _version_ | 1828900161334542336 |
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| author | Gin-Ho Lo |
| author_facet | Gin-Ho Lo |
| author_sort | Gin-Ho Lo |
| collection | DOAJ |
| description | Acute esophageal variceal hemorrhage (AEVH) is a severe complication of portal hypertension. Its management has rapidly evolved in recent years. Traditional methods included vasoconstrictor and balloon tamponade. Vasoconstrictors were shown to control approximately 80% of the bleeding episodes and are generally used as a first-line therapy. Following the use of vasoconstrictors, endoscopic therapy is often used to arrest the bleeding varices and prevent early rebleeding. A meta-analysis showed that the combination of vasoconstrictor and endoscopic therapy is superior to endoscopic therapy alone for controlling AEVH. Balloon tamponade may be used to achieve temporary control of the hemorrhage in case of severe bleeding. A transjugular intrahepatic portosystemic stent shunt may be needed in patients with refractory acute variceal hemorrhage. Surgical intervention is now widely contraindicated during acute variceal hemorrhage, except for patients with good liver reserve. Conversely, apart from the control of acute variceal hemorrhage, prophylactic antibiotics were shown to be helpful in the prevention of bacterial infection and to prevent early variceal rebleeding. With the introduction of new treatment modalities and the measures taken to manage patients with AEVH, the mortality due to AEVH has significantly decreased in recent years. |
| first_indexed | 2024-12-13T15:44:11Z |
| format | Article |
| id | doaj.art-8e5fb55e56cb4f0d9a37b5421770ecba |
| institution | Directory Open Access Journal |
| issn | 1607-551X |
| language | English |
| last_indexed | 2024-12-13T15:44:11Z |
| publishDate | 2010-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Kaohsiung Journal of Medical Sciences |
| spelling | doaj.art-8e5fb55e56cb4f0d9a37b5421770ecba2022-12-21T23:39:45ZengWileyKaohsiung Journal of Medical Sciences1607-551X2010-02-01262556710.1016/S1607-551X(10)70009-7Management of Acute Esophageal Variceal HemorrhageGin-Ho LoAcute esophageal variceal hemorrhage (AEVH) is a severe complication of portal hypertension. Its management has rapidly evolved in recent years. Traditional methods included vasoconstrictor and balloon tamponade. Vasoconstrictors were shown to control approximately 80% of the bleeding episodes and are generally used as a first-line therapy. Following the use of vasoconstrictors, endoscopic therapy is often used to arrest the bleeding varices and prevent early rebleeding. A meta-analysis showed that the combination of vasoconstrictor and endoscopic therapy is superior to endoscopic therapy alone for controlling AEVH. Balloon tamponade may be used to achieve temporary control of the hemorrhage in case of severe bleeding. A transjugular intrahepatic portosystemic stent shunt may be needed in patients with refractory acute variceal hemorrhage. Surgical intervention is now widely contraindicated during acute variceal hemorrhage, except for patients with good liver reserve. Conversely, apart from the control of acute variceal hemorrhage, prophylactic antibiotics were shown to be helpful in the prevention of bacterial infection and to prevent early variceal rebleeding. With the introduction of new treatment modalities and the measures taken to manage patients with AEVH, the mortality due to AEVH has significantly decreased in recent years.http://www.sciencedirect.com/science/article/pii/S1607551X10700097acute variceal hemorrhagebanding ligationsclerotherapyvasoconstrictors |
| spellingShingle | Gin-Ho Lo Management of Acute Esophageal Variceal Hemorrhage Kaohsiung Journal of Medical Sciences acute variceal hemorrhage banding ligation sclerotherapy vasoconstrictors |
| title | Management of Acute Esophageal Variceal Hemorrhage |
| title_full | Management of Acute Esophageal Variceal Hemorrhage |
| title_fullStr | Management of Acute Esophageal Variceal Hemorrhage |
| title_full_unstemmed | Management of Acute Esophageal Variceal Hemorrhage |
| title_short | Management of Acute Esophageal Variceal Hemorrhage |
| title_sort | management of acute esophageal variceal hemorrhage |
| topic | acute variceal hemorrhage banding ligation sclerotherapy vasoconstrictors |
| url | http://www.sciencedirect.com/science/article/pii/S1607551X10700097 |
| work_keys_str_mv | AT ginholo managementofacuteesophagealvaricealhemorrhage |