Girotra M, Raghavapuram S, Abraham RR, Pahwa M, Pahwa AR, Rego RF. Management of gastric variceal bleeding: Role of endoscopy and endoscopic ultrasound. World J Hepatol 2014; 6(3): 130-136 [PMID: 24672642 DOI: 10.4254/wjh.v6.i3.130]
Corresponding Author of This Article
Mohit Girotra, MD, Division of Gastroenterology and Hepatology, Department of Medicine, University of Arkansas for Medical Sciences (UAMS), 4301 W. Markham Street, Shorey S8-68, Mailslot # 567, Little Rock, AR 72202, United States. mgirotra@uams.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Mar 27, 2014; 6(3): 130-136 Published online Mar 27, 2014. doi: 10.4254/wjh.v6.i3.130
Management of gastric variceal bleeding: Role of endoscopy and endoscopic ultrasound
Mohit Girotra, Saikiran Raghavapuram, Rtika R Abraham, Mrinal Pahwa, Archna R Pahwa, Rayburn F Rego
Mohit Girotra, Rayburn F Rego, Division of Gastroenterology and Hepatology, Department of Medicine, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR 72202, United States
Saikiran Raghavapuram, Department of Medicine, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR 72202, United States
Rtika R Abraham, Department of Geriatrics, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR 72202, United States
Mrinal Pahwa, Department of Surgery, Sir Ganga Ram Hospital, New Delhi 110060, India
Archna R Pahwa, Department of Pathology, Lady Hardinge Medical College (LHMC), New Delhi 110001, India
Author contributions: All authors contributed to this work.
Correspondence to: Mohit Girotra, MD, Division of Gastroenterology and Hepatology, Department of Medicine, University of Arkansas for Medical Sciences (UAMS), 4301 W. Markham Street, Shorey S8-68, Mailslot # 567, Little Rock, AR 72202, United States. mgirotra@uams.edu
Telephone: +1-501-6865175 Fax: +1-501-6866248
Received: October 29, 2013 Revised: February 11, 2014 Accepted: February 16, 2014 Published online: March 27, 2014
Core Tip
Core tip: This mini-review addresses endoscopic management principles for gastric variceal bleeding. Endoscopic variceal obliteration (EVO) with tissue adhesives is the currently accepted strategy for controlling bleeding and eradicating gastric varices (GVs). EVO is deemed better than both variceal ligation and sclerotherapy in randomized controlled trials. One unsettled issue with EVO is if routine reinjection is better than reinjection in case of rebleeding. The experience with combination treatments is still premature. For secondary prophylaxis, EVO, transjugular intrahepatic portosystemic shunt or beta-blocker use is recommended. Emerging use of EUS provides optimism of better diagnosis, improved classification, innovative management strategies and confirmatory tool for eradication of GVs.
