Variceal gastrointestinal bleeding: epidemiology, pathogenesis, management and prophylaxis

Variceal gastrointestinal bleeding is one of the main complications of portal hypertension in patients with cirrhosis. It affects those with decompensated cirrhosis, and its occurrence marks a turning point in the progression of liver disease. Despite therapeutic advances, challenges remain in compr...

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Detalles Bibliográficos
Autores: Padilla-Machaca, P. Martin, Padilla Gonzales, Sergio, Venturelli Romero, Maria Grazia, Cabrera Cabrejos, Maria Cecilia
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:Perú
Institución:Sociedad de Gastroenterología del Perú
Repositorio:Revista de Gastroenterología del Perú
Idioma:español
OAI Identifier:oai:ojs.revistagastroperu.com:article/2038
Acceso en línea:https://revistagastroperu.com/index.php/rgp/article/view/2038
Access Level:acceso abierto
Palabra clave:Hemorragia Gastrointestinal
Hipertensión Portal
Cirrosis Hepática
Varices Esofágicas y Gástricas
Gastrointestinal Hemorrhage
Portal Hypertension
Liver Cirrhosis
Esophageal and Gastric Varices
Descripción
Sumario:Variceal gastrointestinal bleeding is one of the main complications of portal hypertension in patients with cirrhosis. It affects those with decompensated cirrhosis, and its occurrence marks a turning point in the progression of liver disease. Despite therapeutic advances, challenges remain in comprehensive management, particularly in resource-limited settings. Treatment aims to control active bleeding, prevent early rebleeding, and reduce mortality. This review summarizes recent evidence on the pathophysiology, diagnosis, and updated management of variceal gastrointestinal bleeding, including emerging strategies such as early vasoactive therapy, rational use of transfusions, antibiotic prophylaxis, and the key role of timely endoscopy. It also highlights the importance of identifying clinically significant portal hypertension to prevent complications and improve clinical outcomes.