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Related Experiment Videos

Acute gastrointestinal bleeding: Part II.

D Collins1, L I Worthley

  • 1Department of Critical Care Medicine, Flinders Medical Centre, Adelaide, SA, Australia.

Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine
|April 14, 2006
PubMed
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Acute esophageal variceal bleeding in critically ill patients is often managed with octreotide and variceal ligation. Persistent bleeding may require transjugular intrahepatic portosystemic shunt or surgical shunt interventions.

Area of Science:

  • Gastroenterology
  • Critical Care Medicine
  • Hepatology

Background:

  • Esophageal varices are a frequent cause of upper gastrointestinal bleeding in patients with portal hypertension.
  • Effective management of acute variceal bleeding is crucial in critically ill patients.

Purpose of the Study:

  • To review the management strategies for acute gastrointestinal bleeding in critically ill patients.
  • To present a two-part overview of current treatment approaches.

Main Methods:

  • A MEDLINE search of English-language literature from 1991 to 2001.
  • Review of articles and studies focusing on acute gastrointestinal bleeding.

Main Results:

  • Octreotide is effective for acute variceal bleeding, with fewer side effects than vasopressin or glypressin.

Related Experiment Videos

  • Variceal ligation has largely replaced endoscopic variceal sclerosis for hemostasis.
  • Balloon tamponade and fibrinolytic inhibitors are used for refractory bleeding before repeat endoscopy.
  • Transjugular intrahepatic portosystemic shunt or surgical shunt are considered for banding-resistant variceal bleeding.

    • Conclusions:

    • Acute esophageal variceal bleeding can often be managed effectively with octreotide and variceal ligation.
    • Transjugular intrahepatic portosystemic shunt or surgical shunt are options for persistent bleeding.