Anne T WolfMD and Norman D GraceMD

The complications of portal hypertension—gastrointestinal hemorrhage, varices, ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, portal systemic encephalopathy—present significant challenges with regard to the management of, and remain significant causes of morbidity and mortality in, patients with end-stage liver disease. These complications are manifestations of hepatic decompensation and their presence warrants consideration of liver transplantation. This chapter will discuss the management of the most morbid complication of portal hypertension, variceal hemorrhage.

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