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Medline ® Abstract for Reference 8

of 'Role of transjugular intrahepatic portosystemic shunts in the treatment of variceal bleeding'

Variceal bleeding. What are the treatment options?
Stein C, Korula J
Postgrad Med. 1995;98(6):143.
Management of variceal hemorrhage is complex and can be difficult. Initially, the severity of the bleeding episode must be assessed and the intravascular volume repleted. Several treatment options are available. A trial of pharmacologic therapy (eg, vasopressin) may control acute bleeding. Temporary balloon tamponade of varices is helpful if bleeding continues. Endoscopic sclerotherapy and variceal ligation appear to be equally beneficial, although fewer complications have been reported with the latter. Transjugular intrahepatic portacaval shunt (TIPS) and portal-systemic shunt surgery are alternatives when endoscopic therapy fails; TIPS is preferred in patients awaiting liver transplantation. Ultimately, the choice of treatment is based on the expertise available at each medical center.
Department of Medicine, University of Southern California School of Medicine, Los Angeles, USA.