Park Min Kyung, Lee Yun Bin
Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2021 Sep 25;78(3):152-160. doi: 10.4166/kjg.2021.113.
Varices are a frequent complication of liver cirrhosis and a major cause of mortality in patients with liver cirrhosis. Patients with decompensated cirrhosis complications have a poor prognosis and require careful management. Portal hypertension is the most common complication of liver cirrhosis, which is the key determinant for varices development. Increased intrahepatic vascular resistance to portal flow leads to the development of portal hypertension. Collateral vessels develop at the communication site between the systemic and portal circulation with the progression of portal hypertension. Varices are the representative collaterals, develop gradually with the progression of portal hypertension and may eventually rupture. Variceal bleeding is a major consequence of portal hypertension and causes the death of cirrhotic patients. The present paper reviews the latest knowledge regarding the diagnosis and management of esophageal and gastric variceal bleeding.
静脉曲张是肝硬化常见的并发症，也是肝硬化患者死亡的主要原因。失代偿期肝硬化并发症患者预后较差，需要精心管理。门静脉高压是肝硬化最常见的并发症，是静脉曲张发生的关键决定因素。肝内血管对门静脉血流的阻力增加导致门静脉高压的发生。随着门静脉高压的进展，在体循环和门静脉循环的交通部位会形成侧支血管。静脉曲张是典型的侧支血管，随着门静脉高压的进展逐渐形成，最终可能破裂。静脉曲张破裂出血是门静脉高压的主要后果，可导致肝硬化患者死亡。本文综述了食管和胃静脉曲张破裂出血诊断和管理的最新知识。
