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Author: Danielle Fullwood
Date: August 2012
Journal: Nursing Standard
Issue: Volume 26, Number 48
Keywords: Balloon tamponade, band ligation, liver cirrhosis, oesophageal varices, portal hypertension, variceal haemorrhage
Portal hypertension is a complication seen in patients with liver cirrhosis
and is characterised by high pressure in the portal vein. As portal
hypertension worsens, varices can form, leading to increased morbidity and
mortality if these rupture. Bleeding can be prevented with pharmacological
agents and endoscopic therapy; however, some patients will experience
variceal haemorrhage. Medical and nursing management of acute variceal
haemorrhage is key to a successful outcome, and after initial resuscitation,
endoscopic therapy should be undertaken. Long-term management to
prevent re-bleeding may involve surgery to implant shunts, which aim to
reduce portal venous pressure. However, patients often require referral to
specialist centres for transplant assessment.
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