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GastroEnterology

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Question:

What are the treatment options of varices?

Author: H K



Answer:

Resuscitation and hemodynamic stabilization, combination of pharmacology and endoscopic rx, TIPS and shunts surgery in refractory cases. Pharmacology tx (somatostatin/octreotide: immediately started to reduce portal pressure, improve dx and Rx success; Vasopressin/Terlipressin: potent vasoconstrictors to decrease splanchnic arterial pressure, used under close monitor) Endoscopic tx (Sclerotherapy [obliterating varicoseal veins by adding sclerosing agents controls hemorrhage 60-100% of cases, complications include chest pain, fever, dysphagia, pleural effusion, esophageal ulcers] Band ligation [placement of elastic band over the varix causing vein strangulation controls bleed 90% w/risk of 30% for rebleeding, fewer complications than sclerotherapy


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H K
H K