Portal Hypertension and Gastrointestinal Bleeding

Jaime Bosch; Juan G. Abraldes; Annalisa Berzigotti; Juan Carlos Garcia-Pagan

doi:10.1055/s-2008-1040318

Seminars in Liver Disease, Table of Contents

Semin Liver Dis 2008; 28(1): 003-025
DOI: 10.1055/s-2008-1040318

Portal Hypertension and Gastrointestinal Bleeding

Jaime Bosch¹ ^, ² , Juan G. Abraldes¹ ^, ² , Annalisa Berzigotti³ ^, ⁴ , Juan Carlos Garcia-Pagan¹ ^, ²

¹Hepatic Hemodynamic Laboratory, Liver Unit, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain
²Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona, Spain
³Centre Diagnostic per la Imatge, Hospital Clinic, Barcelona, Spain
⁴Department of Internal Medicine, Cardioangiology, Hepatology, Policlinico S. Orsola, University of Bologna, Italy

Abstract

ABSTRACT

Variceal bleeding is one of the most serious complications of portal hypertension. The driving force for the development of varices is an increase in portal pressure. As portal hypertension progresses, varices dilate until they finally rupture and bleed. This sequence of events might be prevented by achieving a sufficient decrease in portal pressure or by acting locally at the varices with endoscopic treatments. This article reviews the rationale for the management of portal hypertension and the current recommendations for the prevention and treatment of variceal bleeding.

KEYWORDS

Cirrhosis - varices - endoscopic band ligation - TIPS - β-adrenergic blockers - hepatic venous pressure gradient

Full Text

References

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Professor Jaime BoschM.D. Ph.D.

Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clínic, Villarroel 170

08036 Barcelona, Spain

Email: jbosch@clinic.ub.es