Varices: Esophageal, Gastric, and Rectal

Clin Liver Dis. 2019 Nov;23(4):625-642. doi: 10.1016/j.cld.2019.07.005. Epub 2019 Aug 30.

Abstract

Gastrointestinal varices are associated with cirrhosis and portal hypertension. Variceal hemorrhage is a substantial cause of morbidity and mortality, with esophageal and gastric varices the most common source and rectal varices a much less common cause of severe gastrointestinal bleeding. The goals of managing variceal hemorrhage are control of active bleeding and prevention of rebleeding. This article focuses on reviewing the current management strategies, including optimal medical, endoscopic, and angiographic interventions and their clinical outcomes to achieve these goals. Evidence based discussion is used with current references as much as possible.

Keywords: Band ligation; Esophageal varices; Gastric varices; Hematochezia; Portal hypertension; Rectal varices; Sclerotherapy; UGI bleed.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Cyanoacrylates / therapeutic use
  • Endoscopy, Digestive System
  • Esophageal and Gastric Varices / etiology
  • Esophageal and Gastric Varices / therapy*
  • Fluid Therapy
  • Gastrointestinal Agents / therapeutic use
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / prevention & control*
  • Gastrointestinal Hemorrhage / therapy
  • Hemostasis, Endoscopic
  • Humans
  • Hypertension, Portal / complications*
  • Ligation
  • Octreotide / therapeutic use
  • Proctoscopy
  • Rectum / blood supply*
  • Sclerotherapy
  • Varicose Veins / etiology
  • Varicose Veins / therapy

Substances

  • Adrenergic beta-Antagonists
  • Cyanoacrylates
  • Gastrointestinal Agents
  • Octreotide