Endoscopy Endoscopic hemostasis For Variceal Bleeding скачать в хорошем качестве

Endoscopy Endoscopic hemostasis For Variceal Bleeding

Endoscopic haemostasis is a cornerstone in the management of variceal bleeding, a life-threatening complication of portal hypertension, especially in patients with liver cirrhosis. 🔧 Key Endoscopic Techniques for Variceal Bleeding Endoscopic Variceal Ligation (EVL) The first-line treatment for esophageal varices. Involves placing rubber bands around bleeding varices to stop hemorrhage. Preferred over sclerotherapy due to fewer complications and better outcomes. Endoscopic Injection Sclerotherapy (EIS) Involves injecting a sclerosant into or around the varix. Now largely replaced by EVL but may still be used in certain cases. Tissue Adhesives (e.g., cyanoacrylate) Used primarily for gastric varices, which are less amenable to banding. The glue rapidly polymerizes, sealing the bleeding vessel. Balloon Tamponade or Self-Expanding Metal Stents (SEMS) Temporizing measures when bleeding is uncontrollable by standard endoscopy. Used as a bridge to more definitive therapy like TIPS (Transjugular Intrahepatic Portosystemic Shunt). 🩺 Adjunctive Measures Vasoactive agents (e.g., octreotide, terlipressin) should be started early to reduce portal pressure. Antibiotic prophylaxis is essential to prevent infections, which are common in these patients. Blood transfusion should follow a restrictive strategy (target hemoglobin 70–90 g/L). 🔄 Follow-Up Repeat EVL sessions every 2–4 weeks until variceal eradication. Surveillance endoscopy every 3–6 months in the first year post-eradication #Endoscopy