Management of Gastric and Ectopic Varices

AbstractPurpose of ReviewGastric varices (GV) are seen commonly in patients with portal hypertension and esophageal varices, more so in variceal bleeders. Compared to esophageal varices, there is limited data on the management of GV and ectopic varices. The current review provides a practical and updated approach for the management of patients with GV and ectopic varices.Recent FindingsThe management of isolated gastric varices (IGV) and esophageal varices continuing on the greater curvature of the stomach, the gastro-esophageal varices type 2 (GOV2) has improved significantly. Control of active bleed or prevention of rebleeding from these varices can be achieved by obturating them using endoscopic cyanoacrylate (CYA) glue injection in the majority of cases with or without the addition of beta-blocker therapy. Endoscopic ultrasound-guided coil (with/without CYA glue) injection and endovascular approaches such as transjugular intrahepatic porto-systemic shunt (TIPS) and balloon-occluded/plug-assisted retrograde transvenous occlusion (BRTO/PARTO) alone or in combination are helpful in difficult cases or uncontrolled bleeding. Similarly, in ectopic variceal bleeding, apart from endotherapy with band ligation, sclerotherapy or cyanoacrylate glue injection, TIPS and BRTO are effective approaches in difficult-to-access sites.SummaryMultiple treatment options are now available for GV and ectopic variceal bleed involving endoscopic and endovascular approaches. Depending upon their an...
Source: Current Hepatitis Reports - Category: Infectious Diseases Source Type: research