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Related Concept Videos

Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

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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...
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Esophageal Varices-I: Introduction01:24

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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...
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Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies01:20

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The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
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Related Experiment Video

Updated: Jan 18, 2026

Endoscopic Injection Sclerotherapy Assisted by Cyanoacrylate and Clips for Gastroesophageal Varices
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Acute Variceal Bleeding During the SARS-CoV-2 Pandemic: A National Multicenter Observational Study.

Gabriel Allo1, Stefanie Quickert2, Karsten Große3

  • 1Department for Gastroenterology and Hepatology, Faculty of Medicine, University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany.

Journal of Clinical Medicine
|September 13, 2025
PubMed
Summary

The COVID-19 pandemic did not significantly impact patient outcomes for acute variceal bleeding (AVB) in cirrhotic patients in Germany. Management practices for AVB remained resilient, though transjugular intrahepatic portosystemic shunt (TIPS) use increased.

Keywords:
COVID-19acute variceal bleedingcirrhosispandemicportal hypertensionupper gastrointestinal bleeding

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Area of Science:

  • Hepatology
  • Gastroenterology
  • Infectious Diseases

Background:

  • The COVID-19 pandemic posed challenges to global healthcare systems.
  • Concerns arose regarding its impact on chronic liver disease patients, particularly hepatic decompensations like acute variceal bleeding (AVB).

Purpose of the Study:

  • To assess the effect of the COVID-19 pandemic on clinical outcomes in cirrhotic patients experiencing AVB in Germany.
  • To compare patient outcomes before and during the pandemic.

Main Methods:

  • Retrospective national multicenter study.
  • Comparison of patients with cirrhosis and AVB treated at four German tertiary centers.
  • Data collected from pre-pandemic (2016-2020) and pandemic (2020-2022) periods.

Main Results:

  • No significant differences in 6-week mortality (32.2% vs. 30.1%) or rebleeding rates (22.8% vs. 22.3%) between periods.
  • Comparable rates of infections, ICU stay, and intubation.
  • Increased use of transjugular intrahepatic portosystemic shunt (TIPS) placement during the pandemic (23.2% vs. 11.3%).
  • Higher prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) during the pandemic.

Conclusions:

  • Patient-related outcomes for AVB were largely unaffected by the COVID-19 pandemic in German tertiary centers.
  • Critical AVB management practices demonstrated resilience.
  • Increased TIPS utilization and MASLD prevalence warrant further investigation into evolving clinical practices and patient profiles.