Endoscopic Therapy and Radiologic Intervention of Acute Gastroesophageal Variceal Bleeding

다국어 초록 (Multilingual Abstract)

Acute gastroesophageal variceal hemorrhage is a dreaded complication in patients with liver cirrhosis. Endoscopic therapy andradiologic intervention for gastroesophageal bleeding have rapidly developed in the recent decades. Endoscopic treatment is initiallyperformed to stop variceal hemorrhage. For the treatment of esophageal variceal bleeding, endoscopic variceal ligation (EVL) isconsidered the endoscopic treatment of choice. In cases of gastric variceal hemorrhage, the type of gastric varices (GVs) is importantin deciding the strategy of endoscopic treatment. Endoscopic variceal obturation (EVO) is recommended for fundal variceal bleeding.
For the management of gastroesophageal varix type 1 bleeding, both EVO and EVL are available treatment options; however, EVOis preferred over EVL. If endoscopic management fails to control variceal hemorrhage, radiologic interventional modalities could beconsidered. Transjugular intrahepatic portosystemic shunt is a good option for rescue treatment in refractory variceal bleeding. In casesof refractory hemorrhage of GVs in patients with a gastrorenal shunt, balloon-occluded retrograde transvenous obliteration could beconsidered as a salvage treatment.

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