Variceal bleeding is the most severe life-threatening complication of portal hypertension. Currently, clear therapeutic algorithms are used, which include initial general management, fluid replacement, haemosubstitution, antibiotic prophylaxis, vasoactive medication and endoscopic intervention.
A transjugular intrahepatic portosystemic shunt (TIPS) created using a PTFE-covered stent is recommended when these treatment regimens fail. A dedicated oesophageal metal stent or a balloon tamponade can be used as a bridge to the TIPS or in the case of TIPS contraindications.
No selective β-blockers or endoscopic therapy is used in prophylaxis.