Portal Hypertensive Bleeding

Bleeding due to portal hypertension remains a significant cause of morbidity and mortality in cirrhotic patients. Portal hypertension can lead to bleeding from esophageal varices, gastric varices, portal hypertensive gastropathy and ectopic varices. Several methods are employed to control active bleeding from portal hypertension including pharmacological, endoscopic, radiological and surgical. In most centers the initial approach to portal hypertensive bleeding should include adequate resuscitation, reduction of portal pressure using somatostatin analogues, and an attempt at endoscopic therapy. Primary and secondary prophylaxis of portal hypertensive bleeding are established treatment strategies to improve outcome.