The best way to ensure best outcomes for your patient with variceal bleeding is to treat it
Sadly: 1 in 7 bleeds receives no endoscopic therapy
Why? 🧵
#livertwitter
Sadly: 1 in 7 bleeds receives no endoscopic therapy
Why? 🧵
#livertwitter
The top reasons I have seen are:
🚫But the varices weren’t bleeding at the time
✅varices bleeding can be intermittent. #cirrhosis plus hemetemesis and varices at EGD = band
🚫I couldn’t visualize with all the 🩸
✅take time, reposition patient, use eryrhromycin
🚫But the varices weren’t bleeding at the time
✅varices bleeding can be intermittent. #cirrhosis plus hemetemesis and varices at EGD = band
🚫I couldn’t visualize with all the 🩸
✅take time, reposition patient, use eryrhromycin
🚫not comfortable banding
✅phone a friend or transfer quickly
🚫cannot pass bander given patient anatomy
✅time for sclerotherapy (or glue)
✅phone a friend or transfer quickly
🚫cannot pass bander given patient anatomy
✅time for sclerotherapy (or glue)
Mortality due to variceal bleeding is high:
17.7% at 6 weeks
(Driven by Child Class)
The best way to give patients a shot:
1️⃣timely endoscopy with therapeutic intervention
2️⃣prophylactic antibiotics
3️⃣vasoactive drugs (terli or octreotide)
17.7% at 6 weeks
(Driven by Child Class)
The best way to give patients a shot:
1️⃣timely endoscopy with therapeutic intervention
2️⃣prophylactic antibiotics
3️⃣vasoactive drugs (terli or octreotide)
Reference: cghjournal.org/article/S1542-… #livertwitter
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