Acute Variceal Bleeding

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Transjugular Intrahepatic Portosystemic Shunt (TIPS) for GV • Can be 1 st line therapy for uncontrolled GV bleeding if Cyanoacrylate obturation is not available • Initial hemostasis success ~ 90% Garcia-Tsao G et al. Hepatology 2009
TIPS vs Cyanoacrylate Obturation in Prevention of GV re-bleeding • 35 patients in TIPS group vs 37 patients in Cyanoacrylate group • Less re-bleeding in TIPS group – 4 TIPS patients (11 %) and 14 cyanoacrylate patients (38 %) ( P = 0.014) • No difference in survival or complication rate Lo G et al. Endoscopy 2007
Page 1 and 2: Updates in Management of Acute Vari
Page 3 and 4: The Problem • Gastroesophageal Va
Page 5 and 6: Varices Oesophageal Duodenal Gastri
Page 7 and 8: Initial Assessment & Resuscitation
Page 9 and 10: Blood Volume Resuscitation • Main
Page 11 and 12: Management of Coagulopathy • FFP
Page 13 and 14: Vasoactive Drugs • Somatostatin &
Page 15 and 16: Vasoactive Drugs as 1 st line thera
Page 17 and 18: Endoscopic Variceal Ligation (EVL)
Page 19 and 20: Timing of Endoscopy • OGD within
Page 21 and 22: Endoscopic Therapy + Pharmacologica
Page 23 and 24: Endoscopic Banding Ligation (EBL) v
Page 25 and 26: Endoscopic Banding Ligation (EBL) v
Page 27 and 28: Gastric Varices (GV) • Present in
Page 29: Cyanoacrylate Obturation • Tissue
Page 34: EUS guided Cyanoacrylate Injection
Page 37 and 38: EUS guided Cyanoacrylate Injection
Page 39 and 40: Rescue / Alternative Therapy • TI
Page 41 and 42: Early Use of TIPS in Variceal Bleed
Page 43 and 44: Balloon Tamponade • Sengstaken-Bl
Page 45 and 46: Balloon-Occluded Retrograde Transve

Acute Variceal Bleeding

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