Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc
Journal website http://www.gastrores.org

Review

Volume 2, Number 1, February 2009, pages 8-19

Management of Variceal Hemorrhage

Figures

Figure 1.
Figure 1. The management of primary prophylaxis
Figure 2.
Figure 2. Algorithm for the emergency management
Figure 3.
Figure 3. Algorithm of the secondary prophylaxis

Tables

Table 1. Agents forbidden in hemodynamic restitution for variceal hemorrhage
 
Liquid forbidden useReasons
Normal salineWorsen the formation of ascites as well as other extra-vascular fluid accumulation
DextransSide-effect on bleeding times
Hydroxyethyl starchWorsen hepatic function
Ringer’s lactate solutionContraindicated in case of liver dysfunction

 

Table 2. Commonly used sclerosants
 
SclerosantConcentrationVolume/site (ml)The max value of volume/session (ml)Special points
Sodium morrhuate5%4-620Commonly used in China
Ethanolamine oleate5%2-325Commonly used in China
Polidocanol1%1-220n/a
Sodium tetradecyl sulphate0.5%-1.5%5n/aAssociated with more complications and seldom used now

 

Table 3. Schedule of endoscopy surverillance
 
Time frameIntervals between re-endoscopy
≤ 2 years after eradication3 - 6 months
> 2 and ≤ 3 years after eradication6 - 12 months
> 3 years after eradication till death12 months