tailieunhanh - Esophageal varices

Document presentation of content: Methodology, literature review, and rationale, pathophysiology, epidemiology, natural history, risk factors, diagnosis and differential diagnosis, management of varices and hemorrhage, guidelines, further reading, and websites. | WGO Practice Guidelines Esophageal varices 1 World Gastroenterology Organisation practice guideline Esophageal varices June 2008 Review team Prof. P. Dite Co-Chairman Czech Republic Prof. D. Labrecque Co-Chairman USA Prof. Michael Fried Switzerland Prof. A. Gangl Austria Prof. . Khan Pakistan Prof. D. Bjorkman USA Prof. R. Eliakim Israel Prof. R. Bektaeva Kazakhstan Prof. . Sarin India Prof. S. Fedail Sudan Dr. . Krabshuis France Dr. A. Le Mair The Netherlands Contents 1 Introduction 2 Methodology literature review and rationale 3 Pathophysiology 4 Epidemiology 5 Natural history 6 Risk factors 7 Diagnosis and differential diagnosis 8 Management of varices and hemorrhage 9 Guidelines further reading and websites 1 Introduction Esophageal varices are portosystemic collaterals . vascular channels that link the portal venous and the systemic venous circulation. They form as a consequence of portal hypertension a progressive complication of cirrhosis preferentially in the submucosa of the lower esophagus. Rupture and bleeding from esophageal varices are major complications of portal hypertension and are associated with a high mortality rate. Variceal bleeding accounts for 10-30 of all cases of upper gastrointestinal bleeding. World Gastroenterology Organisation 2007 WGO Practice Guidelines Esophageal varices 2 2 Methodology literature review and rationale Key points The guideline must be relevant globally and not only in developed countries. The guideline must take account of different resource levels. The search strategies are precise rather than sensitive. The guideline is a living document that will be updated as new information becomes available. There is a graded evidence system accompanying the guideline that can be used to track new evidence as it appears. Methodology World Gastroenterology Organisation WGO guidelines are not systematic reviews based on a comprehensive review of all available evidence and guidelines that is a field for systematic