Abstract:
:Continued bleeding or early rebleeding is associated with a poor prognosis in patients with variceal haemorrhage. It is not clear why bleeding stops in some patients and continues or restarts in others. It is suggested that secondary haemodynamic changes in the splanchnic circulation after a bleed may contribute to the risk of further bleeding. These changes include the effects of hypotension on portocollateral resistance, the effects of blood in the gut on splanchnic blood flow, and the effects of blood volume expansion on portal venous pressure during resuscitation. These factors, working in concert, cause a secondary rise in portal venous pressure, which may precipitate further bleeding. Treatment aimed at preventing these secondary haemodynamic changes may be beneficial. It is probable that somatostatin and octreotide could act in this way, which may explain their therapeutic efficacy.
journal_name
Gutjournal_title
Gutauthors
McCormick PA,Jenkins SA,McIntyre N,Burroughs AKdoi
10.1136/gut.36.1.100subject
Has Abstractpub_date
1995-01-01 00:00:00pages
100-3issue
1eissn
0017-5749issn
1468-3288journal_volume
36pub_type
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