Acute Variceal Bleeding

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TIPS • Modern covered TIPS stents usually have longer patency • Usually a bridge to more definitive therapy ( e.g. liver transplant)
Early Use of TIPS in <strong>Variceal</strong> <strong>Bleeding</strong> • Garcia-Pagan et al. NEJM 2010 – 63 patients with Child’s C or Child’s B cirrhosis and persistent variceal bleeding – Early TIPS (within 72h) vs EBL + B-blocker, after initial treatment with vasoactive drug + endoscopy
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 32 and 33: Transjugular Intrahepatic Portosyst
Page 34: EUS guided Cyanoacrylate Injection
Page 37 and 38: EUS guided Cyanoacrylate Injection
Page 39: Rescue / Alternative Therapy • TI
Page 43 and 44: Balloon Tamponade • Sengstaken-Bl
Page 45 and 46: Balloon-Occluded Retrograde Transve

Acute Variceal Bleeding

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