Management of portal hypertension and esophageal varices in alcoholic cirrhosis.

Abstract:

:Portal hypertension is a frequent consequence of liver disease, especially alcoholic cirrhosis. Unabated elevations in portal pressure may presage an esophageal variceal hemorrhage. Propranolol or isosorbide therapy is effective in the prophylaxis of variceal bleeding. In patients with acute variceal hemorrhage, endoscopic sclerotherapy or ligation is the best initial intervention. Stapled esophageal transection is often effective when endoscopic management fails. Surgical shunts have a lower associated mortality rate when they are performed electively and involve partial shunting of hepatic blood flow. Transjugular intrahepatic portosystemic shunts are indicated as a salvage procedure or as a bridge to liver transplantation. Ultimately, liver transplantation offers the best survival rate.

journal_name

Am Fam Physician

authors

Trevillyan J,Carroll PJ

subject

Has Abstract

pub_date

1997-04-01 00:00:00

pages

1851-8, 1861-2

issue

5

eissn

0002-838X

issn

1532-0650

journal_volume

55

pub_type

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