Massive upper gastrointestinal bleeding from ruptured gastroesophageal varices is the main complication of portal hypertension and represents a frequent cause of death and of liver transplantation in cirrhotic patients. Formation of varices is an almost unavoidable complication in cirrhosis. Varices are already present in about 40% of compensated asymptomatic patients at diagnosis, and the incidence increases to 90% of patients during long-term follow up. Variceal bleeding is the last step in a chain of events that starts with portal hypertension, followed by the development and growth of the varices, until they eventually bleed. In the Hospital Nacional Edgardo Rebagliati’s gastrointestinal bleeding unit, 18% of 8 365 admitted patients presented variceal rupture. The therapeutic options to stop the bleeding are divided into general and specific. The pharmacological therapy is addressed...

Massive upper gastrointestinal bleeding from ruptured gastroesophageal varices is the main complication of portal hypertension and represents a frequent cause of death and of liver transplantation in cirrhotic patients. Formation of varices is an almost unavoidable complication in cirrhosis. Varices are already present in about 40% of compensated asymptomatic patients at diagnosis, and the incidence increases to 90% of patients during long-term follow up. Variceal bleeding is the last step in a chain of events that starts with portal hypertension, followed by the development and growth of the varices, until they eventually bleed. In the Hospital Nacional Edgardo Rebagliati’s gastrointestinal bleeding unit, 18% of 8 365 admitted patients presented variceal rupture. The therapeutic options to stop the bleeding are divided into general and specific. The pharmacological therapy is addressed...