Abstract

Esophageal varices are collateral veins at the distal esophagus between gastric and azygos veins arising following increased portal
pressure. Vein pressure above 10 mmHg is regarded as portal hypertension, in which portal vein-hepatic vein pressure gradient is
increased. This status is seen as "clinically important portal hypertension" and it is most common in liver cirrhosis. Acid and esophageal
variceal bleeding is the result of portal hypertension, which are the signs of advanced disease with poorer survival rates. Esophageal varices
develop in 30% of the patients with compensated cirrhosis and 60-70% of the patients with decompensated cirrhosis. Varice development
incidence is around 4-12% in cirrhotic patients without varices. Esophageal variceal hemorrhage has high recurrence, mortality, and
morbidity rates requiring immediate medical treatment and these constitute approximately 10% of upper gastrointestinal bleeding, which
is one of the major causes of mortality in patients with cirrhosis. Bleeding develops in 30% of the cirrhotic patients with esophageal varices
diagnosed during endoscopy. The mortality of the first bleeding episode ranges from 25 to 70% and after the first bleeding episode rebleeding
occurs at a rate of 75-80% in six to twelve months. Variceal diameter, grade, degree of red dots, and cirrhosis are among the
factors that increase the risk of variceal bleeding. The risk of bleeding in Grade 1 varices is 8% and a higher grade increases the risk of
bleeding four to five folds. Pharmacological endoscopic and antibiotic treatment constitutes the basis for esophageal variceal bleeding
treatment. In this study, we aimed to evaluate the current approaches to esophageal variceal bleeding.

Key words: Esophageal Variceal Bleeding; Portal Hypertension; Cirrhosis