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Managing liver cirrhotic complications: Overview of esophageal and gastric varices

Clinical and Molecular Hepatology 2020년 26권 4호 p.444 ~ 460
Lesmana Cosmas Rinaldi Adithya, Raharjo Monica, Gani Rino A.,
소속 상세정보
 ( Lesmana Cosmas Rinaldi Adithya ) - Universitas Indonesia Medical Faculty Dr. Cipto Mangunkusumo National General Hospital Department of Internal Medicine
 ( Raharjo Monica ) - Universitas Indonesia Medical Faculty Dr. Cipto Mangunkusumo National General Hospital Department of Internal Medicine
 ( Gani Rino A. ) - Universitas Indonesia Medical Faculty Dr. Cipto Mangunkusumo National General Hospital Department of Internal Medicine

Abstract


Managing liver cirrhosis in clinical practice is still a challenging problem as its progression is associated with serious complications, such as variceal bleeding that may increase mortality. Portal hypertension (PH) is the main key for the development of liver cirrhosis complications. Portal pressure above 10 mmHg, termed as clinically significant portal hypertension, is associated with formation of varices; meanwhile, portal pressure above 12 mmHg is associated with variceal bleeding. Hepatic vein pressure gradient measurement and esophagogastroduodenoscopy remain the gold standard for assessing portal pressure and detecting varices. Recently, non-invasive methods have been studied for evaluation of portal pressure and varices detection in liver cirrhotic patients. Various guidelines have been published for clinicians’ guidance in the management of esophagogastric varices which aims to prevent development of varices, acute variceal bleeding, and variceal rebleeding. This writing provides a comprehensive review on development of PH and varices in liver cirrhosis patients and its management based on current international guidelines and real experience in Indonesia.

키워드

Liver cirrhosis; Hypertension, Portal; Esophageal and gastric varices

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