Why do varices bleed?

R. De Franchis, M. Primignani

Research output: Contribution to journalArticle

Abstract

About one third of cirrhotic patients with esophageal varices eventually bleed from ruptured varices. The incidence of rebleeding is extremely high during the first 6 weeks after the initial bleeding but declines gradually thereafter. Later, the rebleeding risk returns to baseline levels, i.e., equals that of patients who have never bled. The size of varices and the presence of red color signs on the variceal wall are recognized by most investigators as important in assessing the risk of variceal hemorrhage. Prognostic indexes such as the NIEC index, which incorporate the endoscopic signs with clinical data such as the Child-Pugh score, have been shown to predict the probability of first variceal hemorrhage of individual patients reliably. Other important parameters are the presence of ascites and, in alcoholic cirrhotics, the lack of abstinence from alcohol. The presence of endoscopic signs of bleeding or of stigmata of recent bleeding, of large varices, or of liver failure at the time of first bleeding are risk factors for early rebleeding. The most important risk factors for late rebleeding are the presence of large varices, overt signs of hepatic decompensation, the development of hepatocellular carcinoma, and lack of alcohol abstinence.

Original languageEnglish
Pages (from-to)85-101
Number of pages17
JournalGastroenterology Clinics of North America
Volume21
Issue number1
Publication statusPublished - 1992

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Varicose Veins
Hemorrhage
Alcohol Abstinence
Christianity
Bleeding Time
Esophageal and Gastric Varices
Liver Failure
Ascites
Hepatocellular Carcinoma
Color
Research Personnel
Liver
Incidence

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Why do varices bleed? / De Franchis, R.; Primignani, M.

In: Gastroenterology Clinics of North America, Vol. 21, No. 1, 1992, p. 85-101.

Research output: Contribution to journalArticle

De Franchis, R & Primignani, M 1992, 'Why do varices bleed?', Gastroenterology Clinics of North America, vol. 21, no. 1, pp. 85-101.
De Franchis, R. ; Primignani, M. / Why do varices bleed?. In: Gastroenterology Clinics of North America. 1992 ; Vol. 21, No. 1. pp. 85-101.
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