| [ Summary ] |
Massive hemorrhaging from gastric varices (GV) requires immediate attention because it may often be fatal. Since prediction of gastric variceal bleeding is difficult, prophylactic treatment should be provided proactively for large GV (F2 or F3) and GV with erosion and/or red color sign in order to prevent possible hemorrhaging.
It is widely accepted that injection of tissue adhesives should be the first-line treatment for gastric variceal bleeding. However, since the risk of re-bleeding is high due to the complex portal hemodynamics of GV, elective treatment after initial hemostasis is very important. The combined methods using an α-cyanoacrylate monomer and ethanolamine oleate, or balloon occluded transvenous obliteration is effective for this purpose. It is also important to study portal vein hemodynamics prior to treatment, and after treatment, assess its efficacy on endoscopic ultrasonography and multi-detector row CT. |