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Updated: Jul 27, 2026
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Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
Published on: November 15, 2024
[Oesophageal and fundic variceal bleeding].
1Abteilung für Gastroenterologie und Hepatologie, Universitätsspital Genf, Genf.
Therapeutische Umschau. Revue Therapeutique
|June 3, 2006
Summary
Bleeding from oesophageal and fundic varices, common in cirrhosis, requires prompt management. Early medical and endoscopic interventions significantly reduce mortality and morbidity in patients with variceal bleeding.
Area of Science:
- Gastroenterology
- Hepatology
- Internal Medicine
Context:
- Oesophageal and fundic varices are frequent, high-morbidity complications of cirrhosis and portal hypertension.
- Variceal bleeding poses a significant challenge to emergency medical teams and gastroenterologists.
Purpose:
- To outline current best practices for managing acute variceal bleeding.
- To review diagnostic and therapeutic strategies for oesophageal and fundic varices.
Summary:
- Hemodynamic stabilization with plasma expanders and blood products is crucial.
- Antibiotic prophylaxis (norfloxacin or ceftriaxone) and early vasoactive agents (terlipressin, somatostatin, octreotide) improve outcomes.
- Upper endoscopy within 12 hours is recommended for diagnosis and treatment, including rubber band ligation, sclerotherapy, or tissue glue injection.
- Recurrent bleeding may necessitate shunts or embolization, with careful consideration due to high mortality.
Impact:
- Effective management strategies can significantly reduce morbidity and mortality associated with variceal bleeding.
- This review provides a comprehensive overview for clinicians managing patients with portal hypertension and varices.
- Future research directions include optimizing current treatments and exploring novel targets like the coagulation cascade.
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