Esophageal varices and hematemesis in severe cases can lead to significant morbidity and mortality without correct treatment. Esophageal varices and hematemesis can be brought on by a variety of causes, including infection, vascular abnormalities, inflammatory illnesses, trauma, and cancer. Its location, severity, and causes all influence how it is diagnosed, managed, and treated. The field of radiology especially interventional radiology offers quick, efficient, and successful endovascular therapeutic procedures as well as diagnostic imaging tests. Nuclear scintigraphy, computed tomography angiography, and endovascular angiography can all help to pinpoint the cause of bleeding and give the interventional radiologist important information for managing the case. Examples of minimally invasive procedures that have been suggested for the treatment of variceal bleeding include endoscopic sclerotherapy (ES), variceal ligation (EVL), transjugular intrahepatic portosystemic shunt (TIPS), percutaneous trans-hepatic embolization of gastroesophageal varices (PEGV), and other combined therapies. TIPS had a significant drawback in that it might aggravate liver failure and roughly increase the likelihood of encephalopathy while being quite successful in decreasing portal pressure and preventing rebleeding.
1. Arabi M, Gemmete JJ, Arabi Y. The role of interventional radiology in the management of hemodynamically compromised patients. Intensive Care Med. 2018;44(8):1334-8. doi:10.1007/s00134-018-5236-3
2. Shaheen AA, Nguyen HH, Congly SE, Kaplan GG, Swain MG. Nationwide estimates and risk factors of hospital readmission in patients with cirrhosis in the United States. Liver Int. 2019;39(5):878-84.
3. Yoon H, Shin HJ, Kim MJ, Han SJ, Koh H, Kim S, et al. Predicting gastroesophageal varices through spleen magnetic resonance elastography in pediatric liver fibrosis. World J Gastroenterol. 2019;25(3):367-77.
4. Nery F, Correia S, Macedo C, Gandara J, Lopes V, Valadares D, et al. Nonselective beta-blockers and the risk of portal vein thrombosis in patients with cirrhosis: results of a prospective longitudinal study. Aliment Pharmacol Ther. 2019;49(5):582-8.
5. Nigatu A, Yap JE, Lee Chuy K, Go B, Doukky R. Bleeding Risk of Transesophageal Echocardiography in Patients with Esophageal Varices. J Am Soc Echocardiogr. 2019;32(5):674-6.
6. Paternostro R, Reiberger T, Bucsics T. Elastography-based screening for esophageal varices in patients with advanced chronic liver disease. World J Gastroenterol. 2019;25(3):308-29. doi:10.3748/wjg.v25.i3.308
7. Lee HA, Kim SU, Seo YS, Lee YS, Kang SH, Jung YK, et al. Prediction of the varices needing treatment with non-invasive tests in patients with compensated advanced chronic liver disease. Liver Int. 2019;39(6):1071-9. doi:10.1111/liv.14036
8. Chakinala RC, Kumar A, Barsa JE, Mehta D, Haq KF, Solanki S, et al. Downhill esophageal varices: a therapeutic dilemma. Ann Transl Med. 2018;6(23):463.
9. Meseeha M, Attia M. Esophageal Varices. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448078/
10. Laine L. Interventions for Primary Prevention of Esophageal Variceal Bleeding. Hepatology. 2019;69(4):1382-4.
11. Reiberger T, Bucsics T, Paternostro R, Pfisterer N, Riedl F, Mandorfer M. Small Esophageal Varices in Patients with Cirrhosis-Should We Treat Them? Curr Hepatol Rep. 2018;17(4):301-15.
12. Pfisterer N, Riedl F, Pachofszky T, Gschwantler M, König K, Schuster B, et al. Outcomes after placement of a SX-ELLA oesophageal stent for refractory variceal bleeding-A national multicentre study. Liver Int. 2019;39(2):290-8.
13. Aggeletopoulou I, Konstantakis C, Manolakopoulos S, Triantos C. Role of band ligation for secondary prophylaxis of variceal bleeding. World J Gastroenterol. 2018;24(26):2902-14.
14. Zampino R, Lebano R, Coppola N, Macera M, Grandone A, Rinaldi L, et al. The use of nonselective beta-blockers is a risk factor for portal vein thrombosis in cirrhotic patients. Saudi J Gastroenterol. 2018;24(1):25-9.
15. Wu X, Xuan W, Song L. Transjugular intrahepatic portosystemic stent shunt placement and embolization for hemorrhage associated with rupture of anorectal varices. J Int Med Res. 2018;46(4):1666-71.
16. Monreal-Robles R, Cortez-Hernández CA, González-González JA, Abraldes JG, Bosques-Padilla FJ, Silva-Ramos HN, et al. Acute Variceal Bleeding: Does Octreotide Improve Outcomes in Patients with Different Functional Hepatic Reserve? Ann Hepatol. 2018;17(1):125-33.
17. Indian Society of Gastroenterology. Indian J Gastroenterol. 2018;37(Suppl 1):1-137. doi:10.1007/s12664-018-0911-4
18. Szczepanik AB, Pielaciński K, Oses-Szczepanik AM, Huszcza S, Misiak A, Dąbrowski WP, et al. Sclerotherapy of esophageal varices in hemophilia patients with liver cirrhosis - a prospective, controlled clinical study. Pol Przegl Chir. 2018;90(1):29-34. doi:10.5604/01.3001.0011.5957
19. Song JE, Kim BS. Endoscopic Therapy and Radiologic Intervention of Acute Gastroesophageal Variceal Bleeding. Clin Endosc. 2019;52(5):407-15. doi:10.5946/ce.2019.178
20. Wu S, Wu Y, Shen Y, Cai S, Zhou Y, Zheng H, et al. Transjugular intrahepatic portosystemic shunt plus embolization for bleeding esophagojejunal varices after total gastrectomy. J Interv Med. 2019;2(4):181-3.
21. Ohs Z, Jones M, Sharma N, Loveridge K. Percutaneous transhepatic embolization of ectopic varices in a patient with portal hypertension presenting with hemorrhagic shock. Cureus. 2021;13(9):e18209. doi:10.7759/cureus.18209
22. Parikh A, Leon D, Ghasemi Rad M, Wynne D, Amaresh A. Percutaneous Transhepatic Embolization of a Bleeding Colic Vein in a Cirrhotic Patient With Massive Hematochezia: A Case Report and Literature Review. Cureus. 2022;14(6):e25736. doi:10.7759/cureus.25736
23. Rodrigues SG, Mendoza YP, Bosch J. Beta-blockers in cirrhosis: Evidence-based indications and limitations. JHEP Rep. 2019;2(1):100063. doi:10.1016/j.jhepr.2019.12.001
24. Eisha RM, Ahmed M, Ahmed SS, Lobna K. Role of Partial Splenic Artery Embolization (PSE) in the Treatment of Hypersplenism. Med J Cairo Univ. 2019;87(December):5093-104. doi:10.21608/mjcu.2019.88436
25. Binmoeller KF. Endoscopic Ultrasound-Guided Coil and Glue Injection for Gastric Variceal Bleeding. Gastroenterol Hepatol (N Y). 2018;14(2):123-6.
26. Gong WD, Xue K, Chu YK, Wang Q, Yang W, Quan H, et al. Percutaneous transhepatic embolization of gastroesophageal varices combined with partial splenic embolization for the treatment of variceal bleeding and hypersplenism. Int J Clin Exp Med. 2015;8(10):19642-51.
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