Management of Gastric Varices

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Presentation transcript:

Management of Gastric Varices Juan Carlos Garcia-Pagán, Marta Barrufet, Andres Cardenas, Àngels Escorsell Clinical Gastroenterology and Hepatology Volume 12, Issue 6, Pages 919-928.e1 (June 2014) DOI: 10.1016/j.cgh.2013.07.015 Copyright © 2014 AGA Institute Terms and Conditions

Figure 1 Sarin's classification of GV. Modified with permission from the American Gastroenterological Association (AGA) Institute Gastroslides - Cirrhosis and Portal Hypertension. Clinical Gastroenterology and Hepatology 2014 12, 919-928.e1DOI: (10.1016/j.cgh.2013.07.015) Copyright © 2014 AGA Institute Terms and Conditions

Figure 2 A large gastric varix (IGV1) with a recent nipple sign. Clinical Gastroenterology and Hepatology 2014 12, 919-928.e1DOI: (10.1016/j.cgh.2013.07.015) Copyright © 2014 AGA Institute Terms and Conditions

Figure 3 (A) Basic portosystemic venous anatomy of GV with the classic gastrorenal or splenorenal shunts. (B) Conventional BRTO procedure through transfemoral approach with balloon in the gastrorenal shunt. IVC, inferior vena cava; LGV, left gastric vein; LRV, left renal vein; MV, mesenteric vein; PGV, posterior gastric vein(s); PV, main portal vein; SGV, short gastric vein(s); SV, splenic vein. Afferent vein (thin arrows). Drainage vein (thick arrow). Clinical Gastroenterology and Hepatology 2014 12, 919-928.e1DOI: (10.1016/j.cgh.2013.07.015) Copyright © 2014 AGA Institute Terms and Conditions

Figure 4 Suggested algorithm for management of GV. *EBL in small GV if tissue adhesives not available. HE, hepatic encephalopathy. Clinical Gastroenterology and Hepatology 2014 12, 919-928.e1DOI: (10.1016/j.cgh.2013.07.015) Copyright © 2014 AGA Institute Terms and Conditions