Table 6.

Acute Management of Variceal Hemorrhage

Supportive
• Administer monitor in intensive care unit
• Fluid resuscitation
• Maintain hematocrit near 30 g/dL
• Administer platelets if <50 × 109/L (<56 × 103/mcL)
• Correct coagulopathy
Pharmacologic
• Vasopressin
• Somatostatin
• Octreotide
Endoscopic
• Sclerotherapy
• Band ligation
• Thrombin injection
Mechanical
• Sengstaken-Blakemore tube
Surgical
• Portosystemic shunt
• Esophageal transection
• Transjugular intrahepatic portal shunt (TIPS)
• Liver transplantation