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Treatment of acute variceal bleeding.
Gastroenterol Clin North Am. 1992 Mar; 21(1):103-18.GC

Abstract

Once the bleeding patient has been resuscitated and the diagnosis of acute variceal hemorrhage established by endoscopy, emergency injection sclerotherapy should be employed as the therapeutic option of choice. Endoscopic band ligation is a promising new technique that may prove to be as effective as sclerotherapy, with fewer complications. Pharmacologic treatment (with vasopressin and nitroglycerin) and balloon tamponade remain important alternative treatments, both as empiric temporizing therapy before sclerotherapy can be arranged and in the approximately 30% of patients who continue to bleed after a single sclerotherapy session. Continued bleeding in many of these patients can be controlled with a second session of sclerotherapy. If active acute bleeding persists after two sclerotherapy treatments, treatment should be considered a failure. Some of these patients may be suitable for surgical treatment with either staple-gun transection of the esophagus or emergency portacaval shunting.

Authors+Show Affiliations

Tufts University School of Medicine, Boston, Massachusetts.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

1349002

Citation

Matloff, D S.. "Treatment of Acute Variceal Bleeding." Gastroenterology Clinics of North America, vol. 21, no. 1, 1992, pp. 103-18.
Matloff DS. Treatment of acute variceal bleeding. Gastroenterol Clin North Am. 1992;21(1):103-18.
Matloff, D. S. (1992). Treatment of acute variceal bleeding. Gastroenterology Clinics of North America, 21(1), 103-18.
Matloff DS. Treatment of Acute Variceal Bleeding. Gastroenterol Clin North Am. 1992;21(1):103-18. PubMed PMID: 1349002.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of acute variceal bleeding. A1 - Matloff,D S, PY - 1992/3/1/pubmed PY - 1992/3/1/medline PY - 1992/3/1/entrez SP - 103 EP - 18 JF - Gastroenterology clinics of North America JO - Gastroenterol Clin North Am VL - 21 IS - 1 N2 - Once the bleeding patient has been resuscitated and the diagnosis of acute variceal hemorrhage established by endoscopy, emergency injection sclerotherapy should be employed as the therapeutic option of choice. Endoscopic band ligation is a promising new technique that may prove to be as effective as sclerotherapy, with fewer complications. Pharmacologic treatment (with vasopressin and nitroglycerin) and balloon tamponade remain important alternative treatments, both as empiric temporizing therapy before sclerotherapy can be arranged and in the approximately 30% of patients who continue to bleed after a single sclerotherapy session. Continued bleeding in many of these patients can be controlled with a second session of sclerotherapy. If active acute bleeding persists after two sclerotherapy treatments, treatment should be considered a failure. Some of these patients may be suitable for surgical treatment with either staple-gun transection of the esophagus or emergency portacaval shunting. SN - 0889-8553 UR - https://www.unboundmedicine.com/medline/citation/1349002/Treatment_of_acute_variceal_bleeding_ L2 - https://medlineplus.gov/gastrointestinalbleeding.html DB - PRIME DP - Unbound Medicine ER -