Hipertensión portal: recomendaciones para su evaluación y tratamiento

Stomal varices: An unusual cause of bleeding in patients with portal hypertension

“…Among invasive treatment options, percutaneous sclerotherapy, liver transplant, TIPS and embolization combined or not with TIPS can be performed (3,4,7,8). Among these possibilities, in several studies, TIPS proves to be effective in patients who do not respond to conservative treatment (3,8,9), as the procedure treats the underlying problem of a high portal venous pressure (8,10). However, this technique is not exempt from complications such as hepatic encephalopathy (10).…”

“…The stoma was examined without locating any active bleeding point. The blood analysis revealed the following: Hemoglobin, 4.9 g/dL and platelet count 82,000/ mm 3 . Intensive fluid therapy and transfusions of three red-cell concentrates were administered, achieving hemodynamic stability and blood count improvement.…”

“…They are found outside the gastroesophageal area, mainly at the level of the duodenum, jejunum, ileum, colon, rectum and stomas (1,3). Stomal varices usually develop after colostomy or ileostomy.…”

Congestive Cardiac Hepatopathy

“…In patients with advanced fibrosis, portal hypertension must be due to an added sinusoidal component, since the frequent development of decompressive porto-systemic shunts. In fact, the numerous presence of fistulas between the hepatic and portal veins could be another source of underestimation of sinusoidal pressure [63,64]. Figure 13.7 presents the distinctive features of portal hypertension in FALD.…”

Acute Variceal Bleeding Is It Only the Success of Hemostasis That Guarantees the Positive Outcome?

“…Acute variceal bleeding (AVB) represents 70% of all episodes of upper gastrointestinal bleeding in cirrhotic patients [1], [2]. The introduction of endoscopic therapies (initially sclerotherapy and subsequently endoscopic band ligation), pharmacological therapy (vasopressin, somatostatin, and their analogs), and transjugular intrahepatic portosystemic shunt (TIPS) altered treatment success and prognosis in these patients.…”