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- Cirrhosis of the liver
- Blood clots of the splenic, portal, or hepatic veins
- Arterial-portal venous fistula—abnormal connections between arteries and veins in the liver or spleen
- Certain drugs, including arsenic, azathioprine, methotrexate, and others
- Certain infections, such as schistosomiasis, which is a parasite
- Severe heart failure
- Tumor in pancreas
- Hodgkin's disease
- Chronic alcohol intake
- Chronic vital hepatitis
- NSAID use
- Chronic hepatitis
- Disorders of blood clotting
- Certain parasitic infections
- Vomiting or coughing up blood
- Red, tarry, or very dark stools
- Low blood pressure
- Rapid heartbeat
- Your bodily fluids may need to be tested. This can be done with blood tests.
- Images may need to be taken of your bodily structures. This can be done with ultrasound.
- Your bodily structures may need to be viewed. This can be done with endoscopy.
Endoscopic Band Ligation
Transjugular Intrahepatic Portosystemic Shunting (TIPS)
Distal Splenorenal Shunt (DSRS)
- Seek immediate treatment for long-term alcohol abuse.
- Drugs such as beta-blockers or isosorbide mononitrate could prevent recurrent bleeding.
- Tell your doctor if you are at risk for chronic liver disease, blood clots, or are on medications that may damage the liver.
American College of Gastroenterology http://www.acg.gi.org
American Gastroenterological Association http://www.gastro.org
The Canadian Association of Gastroenterology http://www.cag-acg.org
Canadian Liver Foundation http://www.liver.ca
Berry PA, Wendon JA. The management of severe alcoholic liver disease and variceal bleeding in the intensive care unit. Curr Opin Crit Care . 2006;12:171-7.
Bhasin DK, Siyad I. Variceal bleeding and portal hypertension: new lights on old horizon. Endoscopy . 2004;36(2):120-129.
D’Amico G. The role of vasoactive drugs in the treatment of oesophageal varices. Expert Opinion Pharmacotherapy . 2004;5(2):349-360.
Ferri F, ed. Ferri’s Clinical Advisor 2010. Philadelphia, PA: Mosby Elsevier; 2009.
Gastroesophageal varices. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 19, 2012. Accessed March 20, 2013.
Gastrointestinal hemorrhage, upper tract: variceal. EBSCO Nursing Reference Center website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated March 16, 2012. Accessed March 20, 2013.
Goldman L, Ausiello D, eds. Cecil Textbook of Internal Medicine. 23rd ed. Philadelphia: Saunders, 2008
Kamath PS. Esophageal variceal bleeding: primary prophylaxis. Clin Gastroenterol Hepatol . 2005;3(1):90-93.
Lubel JS, Angus PW. Modern management of portal hypertension. Intern Med J . 2005;35(1):45-9.
Sleisenger M, Fordtran J, Feldman M, Scharschmidt B. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 8th ed. St. Louis, MO: Mosby; 2005.
Villanueva C, Piqueras M, Aracil C, et al. A randomized controlled trial comparing ligation and sclerotherapy as emergency endoscopic treatment added to somatostatin in acute variceal bleeding. J Hepatol .2006;45:560-7
- Reviewer: Daus Mahnke, MD
- Review Date: 09/2012 -
- Update Date: 03/20/2013 -
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
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