Therapeutic modalities in portal hypertension

Eur J Gastroenterol Hepatol. 1997 Jan;9(1):9-11. doi: 10.1097/00042737-199701000-00005.


Optimal medical management is with octreotide or terlipressin (Glypressin) for acute variceal bleeding and combined beta-blocker and nitrate prophylaxis for prevention of rebleeding. Injection sclerotherapy is necessary to arrest acute bleeding, with variceal banding preferred for the obliteration of large varices. Transjugular intrahepatic portosystemic shunts (TIPS) are best used for uncontrolled or recurrent bleeding episodes which fail to respond to endoscopic or drug therapy. They can also rarely be used to treat refractory ascites. Surgical portosystemic shunting and devascularization techniques have now been superseded. Hepatic transplantation should be considered where overall hepatic function is poor.

Publication types

  • Comment
  • Review

MeSH terms

  • Gastrointestinal Hemorrhage / prevention & control
  • Hemodynamics / drug effects
  • Humans
  • Hypertension, Portal / therapy*
  • Pentoxifylline / therapeutic use
  • Portasystemic Shunt, Transjugular Intrahepatic
  • Vasodilator Agents / therapeutic use


  • Vasodilator Agents
  • Pentoxifylline