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Endoscopic Injection Sclerotherapy Assisted by Cyanoacrylate and Clips for Gastroesophageal Varices

Endoscopic Injection Sclerotherapy Assisted by Cyanoacrylate and Clips for Gastroesophageal Varices

Published on: June 13, 2025

Variceal bleeding: management options.

I A Al Mofleh¹, R S Al Rashed, S M Al Amri

¹Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Saudi Journal of Gastroenterology : Official Journal of the Saudi Gastroenterology Association

|October 30, 2009

Summary

This summary is machine-generated.

Portal hypertension causes dangerous esophageal varices bleeding. Treatments range from endoscopic sclerotherapy to surgical shunts and TIPS, aiming to reduce rebleeding and mortality in patients with gastrointestinal bleeding.

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Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy

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Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy

Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy

Published on: June 18, 2020

Area of Science:

Gastroenterology
Hepatology
Interventional Radiology

Background:

Portal hypertension leading to esophageal varices is a significant cause of upper gastrointestinal bleeding.
Variceal bleeding carries substantial risks of rebleeding and mortality.
Effective management strategies are crucial for patient outcomes.

Purpose of the Study:

To review current treatment modalities for esophageal varices and variceal bleeding.
To discuss the efficacy and limitations of various endoscopic, surgical, and interventional procedures.
To highlight the role of transjugular intrahepatic portosystemic stent-shunting (TIPSS) in refractory cases.

Main Methods:

Review of established and emerging treatment options for portal hypertension and esophageal varices.
Discussion of endoscopic sclerotherapy (ES) as a primary treatment.
Exploration of surgical interventions and TIPSS for refractory bleeding.

Main Results:

Endoscopic sclerotherapy (ES), often with vasoactive drugs, is standard for acute variceal bleeding.
Surgical options include esophageal transection, devascularization, and various portosystemic shunts (e.g., DSRS, NDMC, NDPC).
TIPSS is a recent advancement for refractory bleeding, particularly in liver transplant candidates.

Conclusions:

A range of treatments exist for variceal bleeding, tailored to patient condition and refractory status.
Surgical shunt operations have evolved due to complications like encephalopathy.
TIPSS offers a valuable option for managing difficult-to-treat variceal bleeding.