Medical treatment of portal hypertension.
Acta Gastroenterol Belg
; 67(4): 334-43; discussion 344-5, 2004.
Article
em En
| MEDLINE
| ID: mdl-15727078
ABSTRACT
Prevention of the first variceal haemorrhage should start when the patients have developed medium sized to large varices. Non-selective beta-blockers are the first-line treatment; band ligation is roughly equivalent to beta-blockers and is the first choice for patients with contraindications or intolerance to beta-blockers. Treatment of acute bleeding should aim at controlling bleeding and preventing early rebleeding and complications, especially infections. Combined endoscopic and pharmacological treatment with vasoactive drugs can control bleeding in up to 90% of patients. All patients who survive a variceal bleed should be treated with beta-blockers or band ligation to prevent rebleeding. All patients in whom bleeding cannot be controlled or who continue to rebleed can be treated with salvage TIPS or, in selected cases, with surgical shunts. Liver transplantation should be considered for patients with severe liver insufficiency in which first-line treatments fail.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hipertensão Portal
Limite:
Humans
Idioma:
En
Revista:
Acta Gastroenterol Belg
Ano de publicação:
2004
Tipo de documento:
Article
País de afiliação:
Itália