echemi logo
  • Product
  • Supplier
  • Inquiry
    Home > Active Ingredient News > Digestive System Information > One-picture summary: A high-score review of the management of gastric variceal hemorrhage

    One-picture summary: A high-score review of the management of gastric variceal hemorrhage

    • Last Update: 2022-01-25
    • Source: Internet
    • Author: User
    Search more information of high quality chemicals, good prices and reliable suppliers, visit

    Introduction Portal hypertension is a group of syndromes caused by persistent elevation of portal pressure for various reasons, of which liver cirrhosis is the most common cause


    The prevalence of gastric varices (GV) in portal hypertension is 17%-25%, while the prevalence of esophageal varices (EV) is 85%

    In the setting of cirrhosis and portal hypertension, GV occurs in 20% of EV patients, usually due to elevated splenic venous pressure

    Sometimes in the absence of cirrhosis, portal vein occlusion can present with isolated GV

    GVs can bleed at low pressures, are usually more bleed, and have higher rates of transfusion, uncontrolled bleeding, rebleeding, and mortality

    Recently, Gastroenterology (impact factor 22.
    682) published a review that mainly summarizes the management of GV bleeding


    One-figure summary: Management of GV bleeding Treatments for GV bleeding include drug therapy, endoscopic cyanoacrylate injection (ECI), and endovascular intervention

    Although ECI is relatively easy to perform and effective, due to the complexity of shunts and collateral access, this review advocates the use of endovascular procedures for effective treatment, such as balloon occlusion retrograde transvenous occlusion (BRTO), vascular plug-assisted retrograde transvenous occlusion Obliteration (PARTO) or coil-assisted retrograde transvenous occlusion

    The choice of treatment depends on safety, availability of local resources, cost of treatment, and skill level

    If the patient presents with acute bleeding, all GVs should be treated by emergency endoscopy and ECI (Figure 1)

    Figure 1 Approach to the management of GV bleeding *In cases where bleeding persists despite adequate ECI, it should be discussed by a multidisciplinary team including hepatologists, endoscopists, interventional radiologists** Chronic PVT with collaterals BRTOPV, portal vein; PVT, portal vein thrombosis; HE, hepatic encephalopathy; TIPS, transjugular intrahepatic portosystemic shunt; EUS, endoscopic ultrasonography References: Maydeo A, Patil G.
    How to Approach a Patient With Gastric Varices[J].
    2021 Dec 31:S0016-5085(21)04173-1.
    doi: 10.

    This article is an English version of an article which is originally in the Chinese language on and is provided for information purposes only. This website makes no representation or warranty of any kind, either expressed or implied, as to the accuracy, completeness ownership or reliability of the article or any translations thereof. If you have any concerns or complaints relating to the article, please send an email, providing a detailed description of the concern or complaint, to A staff member will contact you within 5 working days. Once verified, infringing content will be removed immediately.

    Contact Us

    The source of this page with content of products and services is from Internet, which doesn't represent ECHEMI's opinion. If you have any queries, please write to It will be replied within 5 days.

    Moreover, if you find any instances of plagiarism from the page, please send email to with relevant evidence.