کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
9401284 | 1288258 | 2005 | 14 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Current Management of Portal Hypertension
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موضوعات مرتبط
علوم پزشکی و سلامت
پزشکی و دندانپزشکی
عمل جراحی
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چکیده انگلیسی
Portal hypertension can lead to life-threatening hemorrhage, ascites, and encephalopathy. This paper reviews the pathophysiology and multidisciplinary management of portal hypertension and its complications, including the indications for and techniques of the various surgical shunts. Variceal bleeding is the most dreaded complication of portal hypertension. It may occur once the portal-systemic gradient increases above 12 mm Hg, occurs in 30% of patients with cirrhosis, and carries a 30-day mortality of 20%. Treatment of acute variceal bleeding includes resuscitation followed by upper endoscopy for sclerosis or band ligation of varices, which can control bleeding in up to 85% of patients. Medical therapies such as vasopressin and somatostatin can also be useful adjuncts. Shunt therapy, preferably the placement of a TIPS, is indicated for refractory acute variceal bleeding. Recurrent variceal bleeding is common and is associated with a high mortality. Therapies to prevent recurrent variceal bleeding include chronic endoscopic therapy, nonselective beta-blockade, operative or nonoperative (TIPS) shunts, devascularization operations, and liver transplantation. Recommendations and a treatment algorithm are provided, taking into account both the etiology and the manifestations of portal hypertension.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Gastrointestinal Surgery - Volume 9, Issue 7, SeptemberâOctober 2005, Pages 992-1005
Journal: Journal of Gastrointestinal Surgery - Volume 9, Issue 7, SeptemberâOctober 2005, Pages 992-1005
نویسندگان
Andrew S. M.D., Layton F. M.D.,