Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA 98111, USA.
J Clin Gastroenterol. 2011 Feb;45(2):133-48. doi: 10.1097/MCG.0b013e3181fbe249.
Gastric varices are less prevalent than esophageal varices, but are associated with an increased mortality with each bleeding episode. This review describes the portal hemodynamics, classification, and management of gastric varices. Management options are outlined based on the most recent literature and according to the clinical presentation of acutely bleeding gastric varices, secondary prophylaxis after bleeding, and primary prophylaxis against an initial bleed. The optimal treatment remains controversial because of the lack of data from large controlled trials. We suggest an algorithm for the management based on the etiology of the gastric varices, severity of the underlying liver disease, and local availability and expertise.
胃静脉曲张比食管静脉曲张少见，但每次出血都会增加死亡率。本文综述了胃静脉曲张的门脉血流动力学、分类和治疗。根据最新文献和急性胃静脉曲张出血的临床表现、出血后二级预防以及初次出血的一级预防，概述了治疗选择。由于缺乏大型对照试验的数据，最佳治疗方法仍存在争议。我们根据胃静脉曲张的病因、基础肝病的严重程度以及当地的可及性和专业知识，提出了一种管理算法。
