RT Book, Section
A1 Reichman, Eric F.
SR Print(0)
ID 57706496
T1 Chapter 63. Balloon Tamponade of Gastrointestinal Bleeding
T2 Emergency Medicine Procedures, 2e
YR 2013
FD 2013
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-161352-1
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=57706496
RD 2024/04/20
AB Gastroesophageal  varices  are  among  the  most  dangerous  complications  associated  with  cirrhosis.  They  are  present  in  50%  to  60%  of  cirrhotic  patients,  and  about  30%  of  them  will  experience  an  episode  of  variceal  hemorrhage  within  2  years  of  the  diagnosis  of  varices.1  The  major  factors  that  determine  the  risk  of  bleeding  are  variceal  size  and  the  degree  of  liver  dysfunction.1–3  While  variceal  bleeding  stops  spontaneously  in  20%  to  30%  of  cases,  it  recurs  in  70%  within  1  year  of  the  initial  episode.1–4  Mortality  is  as  high  as  50%  in  the  first  year.5  Variceal  bleeding  accounts  for  almost  one-third  of  deaths  in  cirrhotic  patients.  Variceal  hemorrhage  has  a  poor  prognosis  if  it  is  associated  with  coexisting  or  subsequent  complications  including  rebleeding,  infection,  hepatic  dysfunction,  and  portal  pressure  ≥12  mmHg.6,7  Somatostatin  and  its  analogs  cause  splanchnic  vasoconstriction  leading  to  reduced  portal  pressure  and  portal  blood  flow  while  venodilators  reduce  portal  pressure  by  reducing  resistance  to  portal  flow.7,8