Screening and Surveillance of Varices in Patients With Cirrhosis

Clin Gastroenterol Hepatol. 2019 Jan;17(1):26-29. doi: 10.1016/j.cgh.2018.03.012. Epub 2018 Mar 15.

Abstract

Gastro-esophageal varices (GEV) and variceal hemorrhage (VH) are clinical milestones in the natural history of cirrhosis, as they are closely related to the severity of portal hypertension and define specific stages in disease progression. Variceal hemorrhage is a life-threatening complication of cirrhosis and is one of the clinical complications that defines cirrhosis decompensation. The goal of screening and surveillance of varices is to identify patients with GEV at a high risk of bleeding, so that prevention strategies can be implemented. There have been significant updates in the management of GEV over the last years, particularly in the use of non-invasive methods to assess the degree of portal hypertension and the likelihood of having GEV. This paper is focused on esophageal varices with or without extension along the lesser curvature (type 1 or GOV1), as special considerations are required for the management of cardiofundal varices (GOV2 - esophageal varices extending into the fundus, or IGV1 - isolated gastric varices in the fundus) or isolated gastric varices type 2 (IGV2 – gastric varices elsewhere in the stomach, not in the fundus).

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Epidemiological Monitoring
  • Esophageal and Gastric Varices / etiology*
  • Esophageal and Gastric Varices / pathology*
  • Gastrointestinal Hemorrhage / etiology*
  • Gastrointestinal Hemorrhage / prevention & control*
  • Humans
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / pathology*
  • Mass Screening / methods*