Document Detail

A practical guide to the management of oesophageal varices.
MedLine Citation:
PMID:  10193686     Owner:  NLM     Status:  MEDLINE    
Bleeding oesophageal varices are a frequent and sometimes fatal complication of portal hypertension. Prompt resuscitation and arrest of haemorrhage are the immediate short term priorities. Vasoactive therapy to reduce portal pressure is administered on presentation. Early endoscopy is necessary to make a definitive diagnosis and initiate appropriate therapy; usually emergency sclerotherapy or banding. After the acute bleeding episode, follow-up therapy is instituted either to obliterate the varices by sclerotherapy or banding, or to chronically lower portal pressure and hence reduce the risk of bleeding pharmacologically; a combination of both strategies may be also used. Active surveillance of those at risk of developing varices is advocated. Long term beta-blocker therapy has been demonstrated to be effective in both the primary prevention of variceal haemorrhage and the prevention of rebleeding in those who have already bled. Despite a multitude of therapeutic regimes and ongoing clinical trials, mortality from this condition remains disappointingly high.
G McCormack; P A McCormick
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Drugs     Volume:  57     ISSN:  0012-6667     ISO Abbreviation:  Drugs     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-06-02     Completed Date:  1999-06-02     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  7600076     Medline TA:  Drugs     Country:  NEW ZEALAND    
Other Details:
Languages:  eng     Pagination:  327-35     Citation Subset:  IM    
The National Liver Unit, St Vincent's Hospital, Dublin, Ireland.
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MeSH Terms
Esophageal and Gastric Varices / drug therapy,  prevention & control,  surgery,  therapy*
Gastrointestinal Hemorrhage / drug therapy,  prevention & control,  surgery,  therapy*
Portasystemic Shunt, Surgical*
Salvage Therapy
Sclerotherapy* / adverse effects
Vasoconstrictor Agents / therapeutic use*
Reg. No./Substance:
0/Vasoconstrictor Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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