Journal
JOURNAL OF CLINICAL GASTROENTEROLOGY
Volume 45, Issue 2, Pages 133-148Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MCG.0b013e3181fbe249
Keywords
gastroesophageal varices; gastric varices; esophageal varices; treatment of gastric varices; portal hemodynamics; management of gastric varices
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Gastric varices are less prevalent than esophageal varices, but are associated with an increased mortality with each bleeding episode. This review describes the portal hemodynamics, classification, and management of gastric varices. Management options are outlined based on the most recent literature and according to the clinical presentation of acutely bleeding gastric varices, secondary prophylaxis after bleeding, and primary prophylaxis against an initial bleed. The optimal treatment remains controversial because of the lack of data from large controlled trials. We suggest an algorithm for the management based on the etiology of the gastric varices, severity of the underlying liver disease, and local availability and expertise.
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