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Related Concept Videos

Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
Varicose Veins II: Diagnostic Studies and Interprofessional Care01:26

Varicose Veins II: Diagnostic Studies and Interprofessional Care

Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
Esophageal Varices-I: Introduction01:24

Esophageal Varices-I: Introduction

Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Venous Thrombosis IV: Nursing Management01:30

Venous Thrombosis IV: Nursing Management

Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
Vascular Spasm01:16

Vascular Spasm

The vascular phase, also known as vasospasm, is the initial stage of hemostasis, crucial for preventing excessive bleeding when a blood vessel is injured. After a vessel is cut, nerves in the damaged area trigger pain and other sensory impulses. Simultaneously, the smooth muscles in the vessel wall contract, resulting in a vascular spasm. This contraction reduces the vessel's diameter at the injury site, slowing or stopping blood loss through the vessel wall. Vascular spasms typically last for...

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Related Experiment Video

Updated: Jun 10, 2026

Endoscopic Injection Sclerotherapy Assisted by Cyanoacrylate and Clips for Gastroesophageal Varices
04:09

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Published on: June 13, 2025

Refractory acute variceal bleeding: what to do next?

Mario D'Amico1, Annalisa Berzigotti, Juan Carlos Garcia-Pagan

  • 1Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, University of Barcelona, Spain.

Clinics in Liver Disease
|August 5, 2010
PubMed
Summary

Current treatments for acute variceal bleeding (AVB) fail in 15-20% of patients. Identifying high-risk individuals early can guide more aggressive therapies to improve outcomes for acute variceal bleeding.

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Last Updated: Jun 10, 2026

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Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
07:10

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Published on: June 18, 2020

Area of Science:

  • Gastroenterology
  • Hepatology
  • Critical Care Medicine

Background:

  • Acute variceal bleeding (AVB) is a serious complication of portal hypertension.
  • Standard treatment involves hemodynamic stabilization, antibiotics, pharmacologic agents, and endoscopy.
  • Despite current guidelines, treatment failure or rebleeding occurs in 15-20% of AVB patients.

Purpose of the Study:

  • To review current management strategies for AVB.
  • To highlight the limitations of existing therapies.
  • To emphasize the need for early identification of high-risk patients for improved prognosis.

Main Methods:

  • Review of current literature and clinical guidelines for AVB management.
  • Analysis of treatment outcomes, including failure rates and rebleeding.
  • Discussion of salvage therapies and their associated risks.

Main Results:

  • Standard AVB treatment fails in 15-20% of cases, necessitating further interventions.
  • Second endoscopic therapies may be attempted for mild bleeding, but severe cases require alternative management.
  • Transjugular intrahepatic portosystemic shunt (TIPS) effectively controls bleeding but carries risks of liver and multiorgan failure.

Conclusions:

  • There is a critical need to identify high-risk AVB patients who are unlikely to respond to standard therapy.
  • Early application of more aggressive treatment strategies in these high-risk patients may improve survival.
  • Future research should focus on predictive markers for treatment failure in AVB.