Bleeding Varices (cont.)

How Are Bleeding Varices Treated?

Bleeding from varices is a medical emergency and treatment should be immediate. If the bleeding is not controlled quickly, a person may go into shock or die. In severe cases, a person may need to be placed temporarily on a ventilator to prevent the lungs from filling with blood. Aside from the urgent need to stop the bleeding, treatment is also aimed at preventing future bleeding. Procedures that help treat bleeding varices include:

  • Banding: A procedure performed by a gastroenterologist in which small rubber bands are placed directly over the varices. This will stop the bleeding and eradicate the varices.
  • Sclerotherapy: A procedure in which a gastroenterologist directly injects the varices with a blood-clotting solution instead of banding them.
  • Transjugular Intrahepatic Portosystemic Shunt (TIPS): A radiological procedure in which a stent (a tubular device) is placed in the middle of the liver. The stent connects the hepatic vein with the portal vein. This procedure is done by placing a catheter through a vein in the neck. It is performed to relieve the high blood pressure that has built up in the liver.
  • Distal Splenorenal Shunt (DSRS): A surgical procedure that connects the splenic vein to the left kidney vein in order to reduce pressure in the varices and control bleeding.
  • Liver transplant: A liver transplant may be done in cases of end-stage liver disease.
  • Devascularization: A surgical procedure that removes the bleeding varices. This procedure is done when a TIPS or a surgical shunt is not possible or unsuccessful in controlling the bleeding.

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