Pharmacological Treatment of Acute Variceal Bleeding

Digestion ◽  
1998 ◽  
Vol 59 (2) ◽  
pp. 28-36 ◽  
Author(s):  
A.K. Burroughs
Keyword(s):  
Variceal Bleeding ◽  
Pharmacological Treatment ◽  
Acute Variceal Bleeding

scholarly journals Emergency Management of Bleeding Esophageal Varices: Drugs, Bands or Sleep?

2006 ◽  
Vol 20 (3) ◽  
pp. 165-170 ◽  
Author(s):  
Brian M Yan ◽  
Samuel S Lee
Keyword(s):  
Emergency Management ◽  
Variceal Bleeding ◽  
Pharmacological Treatment ◽  
Endoscopic Treatment ◽  
Treatment Options ◽  
Pharmacological Treatments ◽  
Balloon Tamponade ◽  
Acute Variceal Bleeding ◽  
Endoscopic Band Ligation ◽  
Meta Analyses

Variceal bleeding is a severe complication of cirrhosis leading to significant morbidity and mortality. Treatment of acute variceal bleeding has improved dramatically since the era of the mechanical balloon tamponade. These advances include endoscopic band ligation or sclerotherapy, and vasoactive pharmacological options such as somatostatin, octreotide, vasopressin and terlipressin. Evidence from a multitude of clinical trials and meta-analyses comparing endoscopic and pharmacological treatments suggests near equivalence in efficacy for initial hemostasis, mortality and rate of rebleeding. This raises the question of whether on-call gastroenterologists should be performing emergency endoscopic treatment in the middle of the night or start pharmacological treatment and delay endoscopy until optimal patient and working conditions the next morning. The present review analyzes the available comparative data between endoscopic and pharmacological treatment options. Although the literature cannot yet definitively answer the question posed, the authors suggest that delaying endoscopic treatment until the next morning may be the most reasonable practical approach.

Efficacy of endoscopic variceal ligation and sclerotheraphy in treatment of acute variceal bleeding

2007 ◽  
Vol 45 (05) ◽  
Author(s):  
C Rédei ◽  
M Szőnyi ◽  
A Zaja ◽  
L Tóth ◽  
Á Svejkovszky ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Endoscopic Variceal Ligation ◽  
Acute Variceal Bleeding

PROGNOSTIC VALUE OF COMBINATION AIMS65 AND MELD SCORES IN CIRRHOTIC PATIENTS WITH ACUTE VARICEAL BLEEDING

2019 ◽  
pp. 35-40
Author(s):  
Thi Nhung Nguyen ◽  
Trung Nam Phan ◽  
Van Huy Tran
Keyword(s):  
Clinical Practice ◽  
Portal Hypertension ◽  
Key Words ◽  
Variceal Bleeding ◽  
Prognostic Value ◽  
High Rate ◽  
Central Hospital ◽  
Acute Variceal Bleeding ◽  
Cirrhotic Patients ◽  
Sensitivity Specificity

Bacground: Variceal bleeding is a severe complication of portal hypertension due to cirrhosis with high rate of motality, hence, predicting early rebleeding and mortality in cirrhotic patients with acute variceal bleeding is vital in clinical practice. Objectives: To evaluate the prognostic value of the combination of AIMS65 and MELD scores in predicting first 5 days in-hospital rebleeding and mortality in cirrhotic patients with acute variceal bleeding. Materials and Methods: 44 cirrhotic patients with acute variceal bleeding hospitalized at Hue Central Hospital. MELD and AIMS65 scores were calculated within the first 24 hours and monitoring rebleeding and mortality in the first 5 days in these patients. Results: AIMS65, MELD scores can predict first 5 days rebleeding and mortality with AUROC are 0.81, 0.69 and 0.92, 0.95, respectively. Combination of AIMS65 and MELD scores can predict first 5 days in hospital rebleeding with AUROC is 0.84, sensitivity 83.3%, specificity 81.6% (p<0.001) and mortality with AUROC is 0.96, sensitivity 100%, specificity 92.7% (p<0.001). Conclusions: The combination of AIMS65 and MELD scores increased the sensitivity, specificity and prognostic value in predicting first 5 days in-hospital rebleeding and mortality in cirrhotic patients with acute variceal bleeding in compare to each single scores. Key words: AiMS65 score, MELd, acute variceal bleeding

scholarly journals Performance of albumin-bilirubin score in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rehab Elsayed Elsafty ◽  
Abdallah Ahmed Elsawy ◽  
Ahmed Fawzy Selim ◽  
Atef Mohamed Taha
Keyword(s):  
Hepatic Encephalopathy ◽  
Variceal Bleeding ◽  
Early Discharge ◽  
Meld Score ◽  
Bleeding Control ◽  
Acute Variceal Bleeding ◽  
Prophylactic Measures ◽  
Significant Performance ◽  
Cirrhotic Patients ◽  
Grade 3

Abstract Background Hepatic encephalopathy exacerbates the morbidity, delays hospital discharge, and increases the rate of readmissions of cirrhotic patients, particularly those are admitted by acute variceal bleeding. We evaluated the performance of albumin-bilirubin score in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding, in comparison to Child-Pugh and MELD scores. This prospective cohort study was conducted on 250 cirrhotic patients who were consecutively presented by acute variceal bleeding in the period from January to December 2020 at Tanta university emergency hospital. Albumin-bilirubin, Child-Pugh, and MELD scores were measured at admission, and then all patients were followed up for 4 weeks after endoscopic bleeding control for possible occurrence of hepatic encephalopathy Results Albumin-bilirubin, Child-Pugh, and MELD scores had significant performances in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding; in this regard, albumin-bilirubin score had the highest accuracy (AUC 0.858, CI 0.802-0.914, sig 0.000) followed by Child-Pugh score (AUC 0.654, CI 0.574–0.735, sig 0.001) and then MELD score (AUC 0.602, CI 0.519–0.686, sig 0.031). The cumulative incidence of hepatic encephalopathy in cirrhotic patients with albumin-bilirubin grade 3 was found to be significantly more than that present in albumin-bilirubin grade 2; most of these hepatic encephalopathy cases occurred in the first 2 weeks of follow-up period. Conclusions Albumin-bilirubin score has a significant performance in risk prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding better than Child-Pugh and MELD scores. Albumin-bilirubin grades could be used as a risk stratifying tool to triage cirrhotic patients who will benefit from early discharge after bleeding control and those patients who will benefit from prophylactic measures for hepatic encephalopathy.

A MELD-Based Model to Determine Risk of Mortality Among Patients With Acute Variceal Bleeding

2014 ◽  
Vol 146 (2) ◽  
pp. 412-419.e3 ◽  
Author(s):  
Enric Reverter ◽  
Puneeta Tandon ◽  
Salvador Augustin ◽  
Fanny Turon ◽  
Stefania Casu ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Acute Variceal Bleeding ◽  
Risk Of Mortality
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