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Digestive Disease Interventions 2023; 07(04): 266-272
DOI: 10.1055/s-0043-1771307
Review Article

Management of Gastric Varices: GI Perspective

Catherine Vozzo 
1   Division of Gastroenterology and Liver Disease, Digestive Health Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio
,
Vibhu Chittajallu
1   Division of Gastroenterology and Liver Disease, Digestive Health Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio
,
Brooke Glessing
1   Division of Gastroenterology and Liver Disease, Digestive Health Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio
,
Ashley Faulx
1   Division of Gastroenterology and Liver Disease, Digestive Health Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio
,
Amitabh Chak
1   Division of Gastroenterology and Liver Disease, Digestive Health Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio
,
Richard C.K. Wong
1   Division of Gastroenterology and Liver Disease, Digestive Health Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio
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Abstract

There is a paucity of literature on the management of gastric varices and current guidelines rely heavily on expert opinion. Optimal treatment of gastric varices requires a multidisciplinary team including gastrointestinal endoscopist, hepatologist, and interventional radiologists. Initial management relies on endoscopic diagnosis followed by therapeutic modalities based on the experience of the endoscopist and the institution. Definitive management may be endoscopic, endovascular, or a combination of the two disciplines. In this review, we discuss endoscopic management of gastric varices with direct endoscopic glue injection, endoscopic ultrasound-guided management, limitations, and adverse events. We conclude by describing a case of gastric variceal bleeding managed with endoscopy when interventional radiographic techniques were not feasible.

Keywords

gastric varices - endoscopy - endoscopic ultrasound - portal hypertension


Publication History

Received: 04 May 2023

Accepted: 12 June 2023

Article published online:
23 August 2023

© 2023. Thieme. All rights reserved.

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