Treatment of bleeding caused by liver cirrhosis-associated portal hypertension - update of Czech Society of Hepatology guidelines
2017
Abstract
Variceal bleeding is one of the severest life threatening complications of portal hypertension. Appropriate treatment includes initial general management, fluid replacement and hemo-substitution, antibiotic prophylaxis, vasoactive medication, and endoscopic treatments.
A transjugular intrahepatic portosystemic shunt (TIPS) is indicated in cases of failure. A dedicated esophageal metal stent or balloon tamponade is sometimes used as a "bridge" to TIPS placement or in cases of TIPS contraindications.
Non-selective β-blockers and endoscopic therapy are used in primary and secondary prophylaxis. The following paper summarises the update to the recommendation of the Czech Society of Hepatology for this treatment.