Gastroesophageal varices: pathogenesis and therapy of acute bleeding
Goff, J.S.
Gastroenterology Clinics of North America 22(4): 779-800
1993
ISSN/ISBN: 0889-8553 PMID: 7905863 Document Number: 420643
Numerous conditions lead to portal hypertension and the development of esophageal or gastric varices, or both. Treatment of patients with acute bleeding should progress in a logical, stepwise fashion. Initial therapy includes vasopressin, somatostatin, or balloon tamponade with a Sengstaken-Blakemore tube. The next step is treatment with sclerotherapy, variceal ligation, or a combination of both. Continued bleeding is managed by more invasive measures, which may include radiologic embolization or shunting, esophageal transection, distal splenorenal shunt, or liver transplantation.