Challenges in the Management of Esophagogastric Varices and Variceal Hemorrhage in Cirrhosis - A Narrative Review

Am J Med. 2024 Mar;137(3):210-217. doi: 10.1016/j.amjmed.2023.12.001. Epub 2023 Dec 20.


Over the past decade, significant advancements in pharmacological, endoscopic, and radiographic treatments have emerged in the management of patients with cirrhosis and esophagogastric varices or variceal hemorrhage. These advances have been in several areas, including the role of screening and primary prophylaxis (preventing an initial variceal bleed), evaluation and management of acute esophagogastric variceal hemorrhage, and in preventing variceal rebleeding. Therefore, we believe there is a need for an updated, evidence-based "narrative review" on this important clinical topic that will be relevant for internists, hospitalists, intensive care unit physicians, and those in training. We believe the guidance presented in this narrative review will enhance daily medical practice of health care professionals and has the potential to improve quality of care for these complex patients.

Publication types

  • Review

MeSH terms

  • Endoscopy
  • Esophageal and Gastric Varices* / diagnosis
  • Esophageal and Gastric Varices* / etiology
  • Esophageal and Gastric Varices* / therapy
  • Gastrointestinal Hemorrhage / prevention & control
  • Gastrointestinal Hemorrhage / therapy
  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / therapy
  • Varicose Veins*