PT  - JOURNAL ARTICLE
AU  - Henderson, J. Michael
AU  - Carey, William D.
AU  - Vogt, David P.
AU  - Barnes, David S.
AU  - Zelch, Margaret G.
AU  - Blake, Cathy
TI  - Management of variceal bleeding in the 1990s
DP  - 1993 Nov 01
TA  - Cleveland Clinic Journal of Medicine
PG  - 431--438
VI  - 60
IP  - 6
4099  - http://www.ccjm.org/content/60/6/431.short
4100  - http://www.ccjm.org/content/60/6/431.full
SO  - Cleve Clin J Med1993 Nov 01; 60
AB  - BACKGROUND Variceal bleeding is a common and serious problem.OBJECTIVE To review the current management of patients with variceal bleeding.SUMMARY Therapeutic options now include pharmacologic reduction of portal hypertension, endoscopic obliteration of varices, placement of decompressive shunts (both surgical and percutaneous), and liver transplantation. Each of these options may be required in different settings. A nonselective beta blocker can prophylactically reduce the risk of an initial bleed. Acute variceal bleeding is best managed by endoscopic sclerosis. Selection of therapy to prevent recurrent bleeding should be based on a full evaluation of the risk of bleeding and of liver failure.CONCLUSIONS Successful management requires a multidisciplinary team, full patient evaluation, and selection of appropriate therapy.