Abstract
Variceal bleeding is a complication of portal hypertension that is still associated with high mortality. Therefore, variceal bleeding is still one of the most dreaded complications in gastroenterology. Management is challenging and is based on rapid cardiorespiratory stabilization of the patient, pharmacological reduction of portal pressure by vasoconstrictors and prevention of infection using antibiotics, as well as endoscopic treatment. The implantation of a transjugular intrahepatic portosystemic shunt (TIPS) within 72 h can improve survival and rebleeding rates in selected cases. Adequate pharmacological (non-selective β‑blocker or carvedilol) and/or endoscopic treatment are recommended for primary and secondary prophylaxis, respectively. This article reviews state-of-the-art management of variceal bleeding.
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