Nezam H. Afdhal, M.D., and Michael P. Curry, M.D. NEJM Volume 362:2421-2422 June 24, 2010 Number 25
Gastroesophageal varices are present in 50% of patients with cirrhosis, and variceal hemorrhage develops in up to one third of these patients.
The risk of variceal hemorrhage is increased in patients who have large varices and advanced stages of liver disease, as assessed on the basis of the Child–Pugh class.1 Several studies published between 1942 and 1981 showed poor outcomes after variceal hemorrhage, with mortality rates of 40% at 6 weeks and 70% at 1 year.2,3,4,5 Over the past five decades, a number of randomized trials have shown an improvement in the efficacy of endoscopic, pharmacologic, surgical, and radiologic techniques . . .
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